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Medical Forum / General / General / August 2006pH related to pressure of CO2?
I don't understand how it is possible for a patient with chronic obstructive pulmonary disease to have a normal extracellular pH while having an increased partial pressure of carbon dioxide. Any ideas? Henry > I don't understand how it is possible for a patient with chronic > obstructive pulmonary disease to have a normal extracellular pH while > having an increased partial pressure of carbon dioxide. Any ideas? > > Henry Intracellular pH is not regulated by carbonate. Bryan > I don't understand how it is possible for a patient with chronic > obstructive pulmonary disease to have a normal extracellular pH while > having an increased partial pressure of carbon dioxide. Any ideas? > > Henry Renal compensation. pH is regulated by kidneys and lung. The pH is related to CO2 and there is a mathematical relationship. When that relationship does not hold then we know compensation is occuring. > > I don't understand how it is possible for a patient with chronic > > obstructive pulmonary disease to have a normal extracellular pH while [quoted text clipped - 5 lines] > related to CO2 and there is a mathematical relationship. When that > relationship does not hold then we know compensation is occuring. Oh, I see. Thanks. Not sure about the mathematical relationship though. I think it's rather when it reaches a certain pH that renal compensation occurs. > > > I don't understand how it is possible for a patient with chronic > > > obstructive pulmonary disease to have a normal extracellular pH while [quoted text clipped - 9 lines] > I think it's rather when it reaches a certain pH that renal > compensation occurs. Acute changes in Paco2 result in predictable changes in pH (the negative log of hydrogen ion concentration) and plasma carbonic acid. This represents the respiratory acid-base change. Although the relation is not completely linear, within clinically relevant ranges it is sufficiently linear to allow the following guideline to estimate the degrees of abnormality resulting from acute changes in Paco2 : For every increase in Paco2 of 20mmHg (2.6 kPa) above normal the pH falls by 0.1 For every decrease of Paco2 of 10mmHg (1.3 kPa) below normal the pH rises by 0.1. Any change in pH outside these parameters is therefore metabolic in origin. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1114160
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