Acidosis and alkalosis are conditions resulting from an imbalance in the body's acid-base homeostasis, affecting the pH level of the blood and other body fluids.
The normal blood pH range is 7.35 to 7.45. A pH below 7.35 indicates acidosis, while a pH above 7.45 indicates alkalosis.
Acidosis
Acidosis occurs due to an excess of acidic substances (e.g., hydrogen ions) or a deficiency of alkaline substances (e.g., bicarbonate), leading to a decreased blood pH.
There are two main types:
I. Respiratory Acidosis
Cause: Impaired gas exchange in the lungs resulting in carbon dioxide (CO2) accumulation.
Conditions: Chronic obstructive pulmonary disease (COPD), severe pneumonia, acute respiratory distress syndrome (ARDS).
Mechanism: Elevated CO2 levels increase carbonic acid concentration in the blood, lowering the pH.
II. Metabolic Acidosis
Cause: Increase in non-respiratory acids or loss of bicarbonate.
Conditions: Lactic acidosis (intense exercise), ketoacidosis (uncontrolled diabetes), kidney failure, ingestion of toxic substances, diarrhea, renal dysfunction.
Mechanism: Accumulation of acids or loss of bicarbonate reduces blood pH.
Alkalosis
Alkalosis occurs due to an excess of alkaline substances or a deficiency of acidic substances, leading to an increased blood pH.
There are two main types:
I. Respiratory Alkalosis
Cause: Hyperventilation leading to excessive CO2 elimination.
Conditions: Anxiety, fever, pain, certain lung diseases.
Mechanism: Decreased CO2 levels reduce carbonic acid concentration in the blood, raising the pH.
II. Metabolic Alkalosis
Cause: Increase in bicarbonate levels or loss of non-respiratory acids.
Conditions: Excessive vomiting (loss of gastric acid), ingestion of alkali substances, certain diuretic medications, endocrine disorders (e.g., primary hyperaldosteronism).
Mechanism: Elevated bicarbonate levels or loss of acids increase blood pH.
Symptoms and Complications
Both acidosis and alkalosis can present with various symptoms, which depend on the severity and duration of the imbalance.
Mild cases may be asymptomatic or cause non-specific symptoms, while severe cases can lead to confusion, muscle weakness, seizures, coma, or death.
Treatment
Treatment involves addressing the underlying cause and correcting the acid-base imbalance:
Interventions: Intravenous fluids, medications, oxygen therapy, and other supportive measures as needed.
Understanding the mechanisms and treatment options for acidosis and alkalosis is crucial for managing these conditions effectively.