Acid Base Balance Associated Abnormalities Creative Paper (Essay Sample)

Acid base balance associated abnormalities
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Respiratory acidosis
The disease is also known as respiratory failure or ventilatory failure. It occurs due to excess carbon dioxide in the body causing a decrease in pH of blood and other bodily fluids. Diseases such as asthma and pneumonia lowers respiratory rate as a result the lungs remove less carbon dioxide produced by the body. The lungs is involved in exchange of respiratory gases, oxygen (O2) is take in to be taken to various body parts whereas carbon dioxide (CO2) is exhaled. Rapid increase in CO2 as a result of alveolar hypoventilation causes an increases the partial pressure of arterial CO2 (PaCO2) above reference range (35-45 mm Hg). Increased PaCO2 leads to imbalance in body ions causing decreases in the ratio of bicarbonate to PaCO2. Excess CO2 in the body causes respiratory acidosis that could be acute or chronic (Roberts et al., 2010). Chronic respiratory acidosis takes more time to develop allowing the body to adapt to increased acidity. The symptoms do not occur since the kidneys produce more bicarbonate that neutralizes excess acids thus maintains pH balance. Excess carbon dioxide combines with water to form carbonic acid that dissociates to form bicarbonate and hydrogen ions (Equation 1). The increased hydrogen ions caused body system to be too acidic and the pH becomes lower than 7.36.
CO2(g) + H2O(l) ↔ H2CO3(aq) ↔ H+(aq)   + HCO3-(aq)…………………………………………1
Acute respiratory acidosis occurs due to abrupt failure of ventilation resulting in elevated PaCO2 above the reference range of 45 mm Hg and decreased pH below 7.35. Depression of the central respiratory center may cause this form of respiratory acidosis. The symptoms of respiratory acidosis include headache, easy fatigue, anxiety, sleeplessness, lethargy, confusion, shortness of breath and blurred vision.
Causes of respiratory acidosis
It is caused by the diseases or conditions that affect the lungs chronic obstructive pulmonary disease (COPD), asthma, emphysema, severe pneumonia and acute pulmonary edema. Severe obesity blocks expansion of lungs during breathing. Anesthetics, narcotics and sedatives or the brain tumors and injuries cause depression in respiratory center of the brain triggering respiratory acidosis. Other causes include obstructed airways, cardiac arrest and muscle weakness (Gray et al., 2008).
Compensatory mechanism
The kidneys respond by excreting more acids through the urine and retain bicarbonate ions. Buffering mechanism involves removal of hydrogen ion by intracellular proteins such as hemoglobin and phosphates. These proteins take up H+ resulting in rise of HCO3 thus increasing pH to optimum.
Treatment
Treatment is aimed at the underlying disease. Oxygen is supplied through ventilation whereas lung diseases are treated using antibiotics. Bronchodilators and diuretics are used to expand airwave and reduce lung pressure.
Respiratory alkalosis
This is a condition where CO2 in the body falls below normal range causing body pH to rise above normal causing body system to be alkaline. Hyperventilation causes increased exchange of O2 for CO2 and too much carbon dioxide is exhaled. This causes decreased levels of CO2 raising body pH leading to alkalosis. Over breathing leads to excretion of CO2 at a rate greater than it is produced resulting in a net PaCO2 reduction. The decreased ratio of PaCO2 to HCO3- results in reduction of H+ and increase in body pH. Acute respiratory alkalosis occurs rapidly resulting in increased body pH above normal range whereas the chronic form takes place slowly and is managed by the kidney.
Causes of respiratory alkalosis
Hyperventilation is the major cause of respiratory alkalosis. Over breathing is caused by lung diseases including pneumonia and asthma or drug abuse, pain, anxiety, pregnancy, heart attack, pulmonary embolism and COPD. Other causes include stress, liver failure and high altitudes. A tumor in the brain other parts of nervous system causes this condition. The symptoms of respiratory alkalosis include dizziness, confusion, agitation, tetany, heart palpitations, numbness, bloating and spasms.
Compensatory mechanism
Buffering and reduced renal acid excretion of carbon dioxide are responsible for compensation to respiratory alkalosis. The kidney responds to the raised body pH by lowering H+ secretion and excreting more of HCO3-. In buffering mechanism, hydrogen ions combine with bicarbonate to form carbonic acid as shown in the equation 2 below. This results in reduction of bicarbonate ions in the blood leading to decrease in pH to correct alkalosis. Hemoglobin, phosphatases and other cellular proteins are source of hydrogen ions for buffering.
 H+(aq)   + HCO3-(aq)     →      H2CO3-(aq)……………………………………………………...……2
Treatment
Treatment aims at underlying cause of respiratory alkalosis. Anxiety related conditions are treated by filling paper bag with carbon dioxide and inhaling the gas to raise CO2 in the body. Oxygen getting into the body can restricted by breathing with one nostril. Reassurance help keep calm the frightening situation and brings breathing rate to normal. Pneumonia is treated using antibiotics.
Metabolic alkalosis
Metabolic alkalosis is accumulation of bicarbonate ions in the serum due to acid loss, alkali administration, HCO3‒ retention resulting in elevation of body ph above normal range (7.35-7.45). The disease manifests itself as alkalemia with pH greater than 7.40.
Causes
Metabolic alkalosis is HCO3‒ accumulation due to increased retention by the kidney. Aldosterone or mineral corticoids hormones stimulate retention of HCO3‒ by the kidney. Other causes include loss of gastric acid through vomiting. Gastric acid (HCL) has hydrogen and chloride ions that are lost during vomiting resulting in alkalosis. Congenital chloride diarrhea, excessive intake of NaHCO3, massive blood transfusion and use of antacid drugs also causes the condition.
Compensatory mechanism
Lung is the main organ that corrects metabolic alkalosis by retaining CO2 through slower breathing (hypoventilation). CO2 combines with water to form carbonic acid that dissociates to Hydrogen ions resulting in a decrease in pH. Renal compensation occurs by increased excretion of HCO3‒ that causes alkalosis.
Treatments
Patients are administered intravenous 0.9% saline solution. Patients with diuretic-induced metabolic alkalosis are given Acetazolamide to increase excretion of bicarbonate ions. Hemodialysis is administered to correct alkalosis in cas...