e-journal

Acid-base physiology: new concepts

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Abstract
The traditional approach to acidebase physiology is based on the HendersoneHasselbalch equation which is derived from the CO2=HCO3
buffer system. However, it is becoming increasingly recognized that this is an incomplete analysis as it focuses on only one of the six reactions involving H þ
and can lead to the incorrect assumption that CO2 and HCO3
are independentlyadjusted factors that ultimately determine pH. In 1983, Stewart, a Canadian physiologist, proposed that a fuller understanding of acid ebase physiology required consideration of biological fluids as a complex
dynamic system, taking into account the interactions of all the chemical species involved. He showed that the true independent variables controlling the pH of any given fluid compartment are: the difference in the concentration of ‘strong ions’, the total concentration of ‘weak acid’, and the PCO2.
Importantly, Hþ and HCO3
are dependent variables and it is incorrect to think of them as being specifically regulated to manipulate pH. This review will discuss the importance of pH homeostasis and highlight the implications of the Stewart approach in our understanding of acidebase control
mechanisms and disorders. In particular, the true mechanisms by which the kidney regulates plasma pH will be discussed, emphasizing key misconceptions that have been propagated as a result of the traditional approach.
Keywords Acidebase physiology; acidosis; Stewart approach

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Ketersediaan

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Informasi Detail

Judul Seri

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No. Panggil

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Penerbit

: Elsevier Ltd., 2015

Deskripsi Fisik

ANAESTHESIA AND INTENSIVE CARE MEDICINE Volume 16:11 November 2015

Bahasa

English

ISBN/ISSN

1472–0299

Klasifikasi

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Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

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Subjek

ANASTESI
FISIOLOGI ASAM-BASA

Info Detail Spesifik

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Pernyataan Tanggungjawab

ETY

Versi lain/terkait

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