III - Keseimbangan Asam Basa

8/10/2019 III - Keseimbangan Asam Basa

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1

ASAM BASA..ASAM BASA..

pHpH

[H[H++

]]


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2

Acid Base

Notasi pH diciptakan oleh seorang ahli kimia dari DenmarkNotasi pH diciptakan oleh seorang ahli kimia dari Denmark

yaitu Soren Peter Sorensen pada thn 1909, yang berarti logyaitu Soren Peter Sorensen pada thn 1909, yang berarti log

negati dari konsentrasi ion hidrogen! Dalam bahasa "ermannegati dari konsentrasi ion hidrogen! Dalam bahasa "erman

disebutdisebutWasserstoffionenexponentWasserstoffionenexponent #eksponen ion hidrogen$#eksponen ion hidrogen$dan diberi simbol pH yang berarti% &dan diberi simbol pH yang berarti% &ppoten'( #po)er$ ooten'( #po)er$ o

HHydrogen!ydrogen!


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3

Acid-Base Balance

Normal pH of body fluids

Arterial blood is 7.4

enous blood and interstitial fluid is 7.3!

"ntracellular fluid is 7.#

Al$alosis or al$alemia arterial blood pH

rises abo%e 7.4!

Acidosis or acidemia arterial pH drops

belo& 7.3!


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4

'ources of Hydro(en "ons

)ost *ydro(en ions ori(inate from cellular

metabolism

Brea$do&n of p*osp*orus-containin( proteins

releases p*osp*oric acid into t*e +,Anaerobic respiration of (lucose produces lactic

acid

at metabolism yields or(anic acids and $etone

bodies

ransportin( carbon dio/ide as bicarbonate

releases *ydro(en ions


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!

Hydro(en "on 0e(ulation

,oncentration of *ydro(en ions is

re(ulated seuentially by

,*emical buffer systems act &it*in seconds

*e respiratory center in t*e brain stem acts

&it*in 1-3 minutes

0enal mec*anisms reuire *ours to days to

effect pH c*an(es


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AcidBase Homeostasis 5%er%ie&AcidBase Homeostasis 5%er%ie&


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0e(ulation of Blood pH

*e lun(s and $idneys play important role in

re(ulatin( blood pH.

*e lun(s re(ulate pH t*rou(* retention or

elimination of ,52by c*an(in( t*e rate and%olume of %entilation.

*e $idneys re(ulate pH by e/cretin( acid6

primarily in t*e ammonium ion NH48

96 and byreclaimin( H,53-from t*e (lomerular filtrate

and addin( it bac$ to t*e blood9.


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:

,arbonic acidbicarbonate buffer system,arbonic acidbicarbonate buffer system

,arbonic acid is formed &*en ,52combines &it* &ater. *is reaction is

catalysed by carbonic an*ydrase

,arbonic acid dissociates spontaneouslyto form a proton and a bicarbonate ion

,52 8 H25 H2,53H8 8 H,53

-

,A


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;

*e


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1#

*e *en *ypercapnia or risin( plasma H8occurs

?eeper and more rapid breat*in( e/pels morecarbon dio/ide

Hydro(en ion concentration is reduced

Al$alosis causes slo&er6 more s*allo&

breat*in(6 causin( H8to increase


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11


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*e 0enal 0e(ulation

,*emical buffers can tie up e/cess acids

or bases6 but t*ey cannot eliminate t*em

from t*e body

*e lun(s can eliminate carbonic acid byeliminatin( carbon dio/ide

5nly t*e $idneys can rid t*e body of

metabolic acids p*osp*oric6 uric6 andlactic acids and $etones9 and pre%ent

metabolic acidosis


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14


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1!

0eabsorption of Bicarbonate


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1

Hydro(en "on +/cretion


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17

CARACARA

TRADISIONAL :TRADISIONAL :

Hendersen-HasselbalchHendersen-Hasselbalch

(1909)(1909)


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1:

pHpH * +!1 log* +!1 log

[HCO[HCO33--]]

pCOpCO22

GINJALGINJAL

PARUPARU

BASABASA

ASAMASAM CO2

HCO3

H-./

-.

ompensasiompensasi

NormalNormal

NormalNormal


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1;

-arbonic acid2bicarbonate buer system-arbonic acid2bicarbonate buer system

*e pa of carbonic acid is .1

,arbonic acid is t*e maor buffer in +,

*e pH of blood can be determined usin(

t*e Henderson-Hasselbalc* euation

H2,53 H8 8 H,53

-

,arbonic acid Bicarbonate ion

pa C .1

+,


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2#

pH C pa 8 lo( DH,53-EDH2,53E

pH C pa 8 lo( DH,53-E0!0// =,52

7.4 C .1 8 lo( 0 2 1

3!4C .1 8 1.3

=lasma pH euals 3!4&*en buffer ratio is 2#1

*e solubility constant of ,52is #.#3

Henderson5Hasselbalch e6uationHenderson5Hasselbalch e6uation


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DUA VARIABELDUA VARIABEL

pH atau [HpH atau [H++] DALAM PLASMA] DALAM PLASMA

DITENTUAN OLEHDITENTUAN OLEH

VARIABELVARIABEL

INDEPENDENINDEPENDEN

'te&art =A. ,an F =*ysiol =*armacol 11444-1416 1;:3.

VARIABELVARIABEL

DEPENDENDEPENDEN

a!a St"#a!t $a!a St"#a!t $


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Deinisi%Deinisi%

Strong ion dierence adalah ketidakseimbanganStrong ion dierence adalah ketidakseimbangan muatanmuatan

dari ion5ion kuat! 7ebih rinci lagi, S8D adalah umlahdari ion5ion kuat! 7ebih rinci lagi, S8D adalah umlah

konsentrasi basa kation kuat dikurangi umlah darikonsentrasi basa kation kuat dikurangi umlah dari

konsentrasi asam anion kuat! :ntuk deinisi ini semuakonsentrasi asam anion kuat! :ntuk deinisi ini semua

konsentrasi ion5ion diekspresikan dalam ekui;alensikonsentrasi ion5ion diekspresikan dalam ekui;alensi#m


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Gamblegram

NaNa88

14#14#

44

,a,a8888)()(8888

,l,l--

1#21#2

A"5N AN"5N

S8DS8D

STRONG IONSTRONG ION

DI%%ERENCEDI%%ERENCE

[Na+] + [K+] + [kation divalen] - [Cl-] - [asam organik kat-]

[Na+] + [K+] - [Cl-] ! ["#$]

1%0 m&' + % m&' - 10* m&' ! % m&'


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SIDSID()* ((++**

[H[H++]] [OH[OH--]]

?alam cairan biolo(is plasma9 d(n su*u 37#,6 '"? *ampir

selalu positif6 biasanya ber$isar 3#-4# m+


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Kombinasi protein dan posfat disebut asamlemah total (total weak acid) [Atot].

Reaksi disosiasinya adalah

[A[Atottot] (KA) ! [A] (KA) ! [A""].[#].[#$$]]

[%rotein #] [%rotein"] $ [#$]

&EA ACID&EA ACID

disosiasi


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Gamblegram

NaNa88

14#14#

44

,a,a8888)()(8888

,l,l--

1#21#2

H,5H,533--

2424

A"5N AN"5N

S8DS8D

=eak acid=eak acid

#Alb5,P5$#Alb5,P5$


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DEPENDENT VARIABLESDEPENDENT VARIABLES

HH++

OHOH--

CO3CO3-- AA--

AHAH

HCO3-HCO3-


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Strong 8onsStrong 8ons

DierenceDierence

p-.p-.

ProteinProtein

-oncentration-oncentration

pHpH

8ND


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NaNa,,

M.M.CaCa

C/C/

22

PPA/0A/0

H-.H-.//* 4* 4

C/C/

11

PPA/0A/0

H-.H-.//55

,sidosishierkloremi

"#$ n"#$

C/C/

22

7aktat2keto*:A

Ketolaktatasidosis

CLCL

11

PP

AlbAlb

SID

Alkalosishipokloremi

K,.#/NK,.#/N ,N#/N,N#/N

H/. * H * 40 m


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encl ?, "abor A, a'da A, igge "! Diagnosis o metabolic acid5base disturbances in

critically ill patients! Am " @espir -rit -are ed 000 DecC1+#+$%4+51


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AS8D.S8S A7A7.S8S

8! @espiratori P-.

P-.

88! Nonrespiratori #metabolik$

1! Eangguan pd S8D

a! elebi*an $e$uran(an airFNaG, S8D

FNaG, S8D

b! etida$seimban(an anion

$uat

i! elebi*an $e$uran(an ,l- F-l5G, S8D F-l5G, S8D

ii! Ada anion ta$ teru$ur F:A5G, S8D

! Eangguan pd asam lemah

i! adar albumin FAlbG FAlbG

ii! adar posp*ate FPiG FPiG

encl ?, "abor A, a'da A, igge "! Diagnosis o metabolic acid5base disturbances in

critically ill patients! Am " @espir -rit -are ed 000 DecC1+#+$%4+51


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@ A B . 7 8

AbnormalAbnormalp-.p-.

AbnormalAbnormalS8DS8D

AbnormalAbnormal=eak acid=eak acid

AlbAlb P.45P.45

AlkalosisAlkalosis

AsidosisAsidosis

TurunTurun

MeningkatMeningkat

TurunTurun

kelebihankelebihan

kekurangankekurangan

PositifPositif meningkatmeningkat

encl 6 Am F 0espir ,rit ,are )ed 2### ?ec@129224-!1

A8@A8@

Anion kuatAnion kuat

-l5-l5 :A5:A5

i!oi!o

i!eri!er


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Anion Eap

?escribed by Iamble in 1;3;

+lectroneutrality

Na86 ,l-6 and H,53are measured ions

Na :- * -l H-./ :A

:-* Sum o unmeasured cations

:A* Sum o unmeasured anions


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Anion Eap

:nmeasured -ations% total 11m+. Acid-Base ?isorders. &&&.acid-base.com
http://www.acid-base.com/http://www.acid-base.com/

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