Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Bench-to-bedside review: Fundamental principles of acid-base physiology. | Critical Care April 2005 Vol 9 No 2 Corey Review Bench-to-bedside review Fundamental principles of acid-base physiology Howard E Corey Director The Children s Kidney Center of New Jersey Atlantic Health System Morristown New Jersey USA Corresponding author Howard E Corey Published online 29 November 2004 This article is online at http content 9 2 184 2004 BioMed Central Ltd Critical Care 2005 9 184-192 DOI cc2985 Abstract Complex acid-base disorders arise frequently in critically ill patients especially in those with multiorgan failure. In order to diagnose and treat these disorders better some intensivists have abandoned traditional theories in favor of revisionist models of acid-base balance. With claimed superiority over the traditional approach the new methods have rekindled debate over the fundmental principles of acid-base physiology. In order to shed light on this controversy we review the derivation and application of new models of acid-base balance. Introduction Master equations All modern theories of acid-base balance in plasma are predicated upon thermodynamic equilibrium equations. In an equilibrium theory one enumerates some property of a system such as electrical charge proton number or proton acceptor sites and then distributes that property among the various species of the system according to the energetics of that particular system. For example human plasma consists of fully dissociated ions strong ions such as Na K Cl-and lactate partially dissociated weak acids such as albumin and phosphate and volatile buffers carbonate species . CB the total concentration of proton acceptor sites in solution is given by Cb C ZCi-i- D 1 Where C is the total concentration of carbonate species proton acceptor sites in mmol l Ci is the concentration of noncarbonate buffer species i in mmol l e-i is the average number of proton acceptor sites per molecule of species i and D is Ricci s difference function D H - OH- . .
