Defense of Hydrogen Ion Concentration in Chronic Metabolic Acidosis
Authors: EDWARD J. LENNON
Journal: Annals of Internal Medicine (1966)

Article1 August 1966Defense of Hydrogen Ion Concentration in Chronic Metabolic AcidosisA New Evaluation of an Old ApproachEDWARD J. LENNON, M.D., JACOB LEMANN JR., M.D.EDWARD J. LENNON, M.D.Search for more papers by this author, JACOB LEMANN JR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-2-265 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe interpretation of disturbances in acid-base metabolism requires knowledge of the hydrogen ion concentration of body fluids and the state of the buffers that defend this concentration. Classically, this information has been obtained by the measurement of whole blood pH and plasma total carbon dioxide content and derivation of [HCO3-] and PCO2 by use of the Henderson-Hasselbalch equation:In this relationship, [HCO3-] = total carbon dioxide content - α PCO2, and α = the solubility coefficient for carbon dioxide at 37 C. Two difficulties exist for the physician using these data in the care of patients. The first is conceptual...References1. HUCKABEE WE: Henderson vs. Hasselbalch. Clin. Res. 9: 116, 1961. Google Scholar2. HENDERSON LJ: The theory of neutrality regulation in the animal organism. Amer. J. Physiol. 21: 427, 1908. CrossrefGoogle Scholar3. SINGERHASTINGS RBAB: Improved clinical method for estimation of disturbances of acid-base balance of human blood. Medicine (Balt.) 27: 223, 1948. CrossrefMedlineGoogle Scholar4. ASTRUPJORGENSENANDERSENENGEL PKOSK: The acid-base metabolism. A new approach. Lancet 1: 1035, 1960. CrossrefMedlineGoogle Scholar5. SCHWARTZRELMAN WBAS: A critique of the parameters used in the evaluation of acid-base disorders. "Whole-blood buffer base" and "standard bicarbonate" compared with blood pH and plasma bicarbonate concentration. New Eng. J. Med. 268: 1382, 1963. CrossrefMedlineGoogle Scholar6. ELKINTON JR: Editorial: Acid-base disorders and the clinician. Ann. Intern. Med. 63: 893, 1965. LinkGoogle Scholar7. BRACKETTCOHENSCHWARTZ NCJJWB: Carbon dioxide titration curve of normal man: effect of increasing degrees of acute hypercapnia on acid-base equilibrium. New Eng. J. Med. 272: 6, 1965. CrossrefMedlineGoogle Scholar8. SCHWARTZBRACKETTCOHEN WBNCJJ: The response of extracellular hydrogen ion concentration to graded degrees of chronic hypercapnia: the physiologic limits of the defense of pH. J. Clin. Invest. 44: 291, 1965. CrossrefMedlineGoogle Scholar9. REFSUM HE: Acid-base status in patients with chronic hypercapnia and hypoxemia. Clin. Sci. 27: 407, 1964. MedlineGoogle Scholar10. DULFANOISHIKAWA MJS: Hypercapnia: mental changes and extrapulmonary complications: an expanded concept of the "CO2 intoxication" syndrome. Ann. Intern. Med. 63: 829, 1965. LinkGoogle Scholar11. RELMANLENNONLEMANN ASEJJ: Endogenous production of fixed acid and the measurement of the net balance of acid in normal subjects. J. Clin. Invest. 40: 1621, 1961. CrossrefMedlineGoogle Scholar12. LENNONLEMANNRELMAN EJJAS: The effects of phosphoproteins on acid balance in normal subjects. J. Clin. Invest. 41: 637, 1962. CrossrefMedlineGoogle Scholar13. GOODMANLEMANNLENNONRELMAN ADJEJAS: Production, excretion, and net balance of fixed acid in patients with renal acidosis. J. Clin. Invest. 44: 495, 1965. CrossrefMedlineGoogle Scholar14. LEMANNLENNONGOODMANLITZOWRELMAN JEJADJRAS: The net balance of acid in subjects given large loads of acid or alkali. Ibid., p. 507. Google Scholar15. MØLLER B: The hydrogen ion concentration in arterial blood. A clinical study of patients with diabetes mellitus and diseases of the kidneys, lungs, and heart. Acta Med. Scand. (suppl. 348) 165: 1, 1959. MedlineGoogle Scholar16. GAMBINO SR: Normal values for adult human venous plasma pH and CO2 content. Amer. J. Clin. Path. 32: 294, 1959. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: EDWARD J. LENNON, M.D.; JACOB LEMANNJR., M.D.Affiliations: Milwaukee, WisconsinFrom the Department of Internal Medicine and the Clinical Research Center, Marquette University School of Medicine and the Milwaukee County Hospital, Milwaukee, Wis.This study was supported in part by grants R01 AM 08924-02 and 5 M01 FR 00058-05, the U. S. Public Health Service, Washington, D. C.Requests for reprints should be addressed to Edward J. Lennon, M.D., Milwaukee County Hospital, 8700 W. Wisconsin Ave., Milwaukee, Wis. 53226. 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REID, M.D.Clinical Disorders of Acid-Base Regulation: A Survey of Seventeen Years' Diagnostic Experience 1 August 1966Volume 65, Issue 2Page: 265-274KeywordsAttentionBlood plasmaCarbon dioxideHospital medicineHypercapniaMedical servicesPartial pressure of carbon dioxidePatientsResearch designResearch laboratories ePublished: 1 December 2008 Issue Published: 1 August 1966 PDF downloadLoading ...