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Keywords: an acid-base equilibrium, an acidosis, an alkalosis, a metabolism, an acid, alkali, buffer systems, ions of Hydrogenium, pH, an acidity, acid-base equilibrium

Infringements of the kislotno-basic state. Aцидозы and alkalosises

Key concepts

1. the Acidosis- the typical pathological process described by absolute or relative augmentation of the maintenance in an organism acidic and decrease of alkaline materials. The gaseous acidosis arises at augmentation pCO₂in an arterial blood (for example, at an alveolar hypoventilation), a nongaseous acidosis - at accumulation in an organism of acidic products of a histic metabolism (for example, at a diabetes).
2. the Alkalosis- the typical pathological process described by absolute or relative augmentation in an organism alkaline or decrease of acidic materials. The gas alkalosis educes at superfluous abjection of Carbonei dioxydum (for example, at a hypobaropathy), not gas alkalosis - at superfluous entering alkaline or abjection of acidic materials (for example, at a pernicious vomiting).
3. the Compensated forms of acidosises and alkalosises- an acid-base equilibrium at which pH blood plasmas it is kept in limens of physiological sizes (rN=7,35-7,45 or with insignificant fluctuations pH: 7,24-7,56 at the subcompensated form). Indemnification is provided with a natural resistance of cellular membranes, delution and a dilution of acidic products of a metabolism in outside of and endocellular fluid, ionoobmenom between an osteal tissue and extracellular fluid, buffer systems (gidrokarbonatnoj, phosphatic, albuminous, gemoglobinovoj) and excretory mechanisms (mild, nephroses, a gastrointestinal path, a liver).
4. Not compensated form of acidosises and alkalosises- an acid-base equilibrium, accompanying with augmentation in a blood plasma of concentration of hydrogen ions at acidosises (rN is lower 7,24) or their decrease at alkalosises (pH is higher 7,56).
5. Parameters of the kislotno-basic state:
• the Gaseous acidosis- augmentation in a blood plasma pCO₂, concentrations of actual and standard hydrocarbonates, moderate rising of a titrate acidity of urine and salts of ammonium in urine;
• the Nongaseous acidosis- decrease in a blood plasma of concentration of actual and standard hydrocarbonates, pCO₂, the sums of the buffer establishments, augmentation of deficiency of the establishments, titratsionoj acidities of urine and salts of ammonium in urine;
• the Gas alkalosis- decrease in a blood plasma pCO₂, concentrations of actual and standard hydrocarbonates, a titrate acidity of urine and salts of ammonium in urine;
• Not gas alkalosis- rising of concentration in a blood plasma of actual and standard hydrocarbonates, compensator augmentation pCO₂, ascending of the sum and excess of the buffer establishments, downstroke of a titrate acidity of urine and salts of ammonium in urine.
6. Blended forms of infringements of the kislotno-basic stateis a combination of gas and not gas acidosises (for example, at a circulatory unefficiency), gas and not gas alkalosises (for example, at a craniocerebral trauma). One of blended forms of an acid-base equilibrium is the combination extracellular metabolic gipokaliemicheskogo an alkalosis and an endocellular acidosis (for example, at a hypercorticoidism) and compensator rising pCO₂

Educational elements

I. The general mechanisms of infringement of the kislotno-basic states (acid-base equilibrium) parameters of an acid-base equilibrium (rN blood plasmas, pCO₂, AB, SB, BB, BE in a blood plasma, a titrate acidity of urine, the maintenance of salts of ammonium in urine)

• acidosises gas and not gas
• alkalosises gas and not gas
• the compensated and not compensated forms of distresses of an acid-base equilibrium

II. Mechanisms of protective - adaptive reactions

• a natural resistance of cellular membranes
• delution and a dilution of acidic and alkaline materials in outside of and endocellular fluid
• buffer mechanisms of indemnification: gemoglobinovyj, gidrokarbonatnyj, phosphatic, albuminous
• ionoobmen (H⁺, Na⁺, K⁺, Ca^{2 +}) between outside of and endocellular fluid
• excretory mechanisms of indemnification: respiratory, renal, gastroenteric

III. Mechanisms of development of a gaseous acidosis

• augmentation of a strain of a carbon dioxide (a flying acid) and the establishments (hydrocarbonates) in a blood plasma
• a hypercapnia, pathological reactions
• buffer mechanisms of indemnification
• compensator metabolic reactions
• compensator excretory reactions: renal and gastroenteric mechanisms parameters of the gaseous acidosis which compensated and has been not compensated

IV. Mechanisms of development of a nongaseous acidosis

• augmentation of formation of intermediate products of an exchange (nonvolatile acids)
• decrease of the maintenance in a blood plasma of the establishments (alkaline reserves), pathological reactions
• buffer mechanisms of indemnification
• compensator metabolic reactions
• compensator excretory reactions: respiratory, renal and gastroenteric mechanisms
• parameters of the nongaseous acidosis which compensated and has been not compensated

V. Mechanisms of development of a gas alkalosis

• decrease of a strain of a carbon dioxide (a flying acid) and the establishments (hydrocarbonates) in a blood plasma
• an acapnia, pathological reactions
• buffer mechanisms of indemnification
• compensator metabolic reactions
• compensator excretory reactions: renal and gastroenteric mechanisms
• parameters of the gas alkalosis which compensated and has been not compensated

VI. Mechanisms of development of not gas alkalosis

• augmentation of the maintenance in a blood plasma of the establishments (alkaline reserves)
• pathological reactions
• buffer mechanisms of indemnification
• compensator metabolic reactions
• compensator excretory reactions: respiratory, renal and gastroenteric mechanisms
• parameters of not gas alkalosis which compensated and has been not compensated

VII. Blended forms of infringements of the kislotno-basic state

• gas and not gas acidosises
• gas and not gas alkalosises
• a nongaseous acidosis and a gas alkalosis

VIII. Secretory forms of infringements of the kislotno-basic state

• a renal acidosis: a diffuse glomerulonephritis, a nephrosis, a nephrosclerosis
• a gastroenteric acidosis: a diarrhea, intestinal and cholic fistulas
• a gastroenteric alkalosis: a pylorostenosis, an intestinal obstruction, a pernicious vomiting

IX. Exogenous forms of infringements of the kislotno-basic state

• an acidosis: a venenating with acids (a carbon dioxide, Salicylases), the long use of acidic nutrition, reception of medicines (Sodium chloridum of ammonium)
• an alkalosis: long reception of alkaline nutrition (mineral water, soda), an infusion of hydrocarbonates and other alkaline solutions

X. A role of an acid-base equilibrium in development of a caries and inflammatory diseases parodonta

XI. The general pathological value of distresses of the kislotno-basic state

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Keywords: an acid-base equilibrium, an acidosis, an alkalosis, a metabolism, an acid, alkali, buffer systems, ions of Hydrogenium, pH, an acidity, acid-base equilibrium

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