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M. GANDUL ATIK YULIANI, MKES., DRH.
LIQUID BODY, ELECTROLYTE
AND BASE ACID BALANCE
I. BALANCE OF WATER AND ELECTROLYTE
II. CONDAYS
THE BALANCE OF WATER AND
ELECTROLYTES
BODY LIQUID PHYSIOLOGY AND EQUIPMENT BALANCE
BODY LIQUID COMPARTMENT
SYSTEM OF BODY LIQUIDS AND ELECTROLYTE
BODY LIQUID PHYSIOLOGY AND
EQUIPMENT BALANCE
ELECTROLYTE: SUBSTANCE OF POSITIVE OR NEGATIVE IN A LIQUID SOLUTION.
CATION: POSITIVE POWERFUL ELECTRICITY
K+, Na+, Ca++, Mg++
ANION: NEGATIVE POWERFUL ELECTROLYTE
Cl-, HCO3-, PROT, AS. ORG, HPO4-, SO4-
BODY FLUIDS
TOTAL LIQUID BODY INFLUENCE BY:
• FAT NETS
• GENDER
• AGE
• SPECIES
USE OF BODY LIQUID
AS MEDIUM REACTION IN THE BODY
EXCHANGE OF CELL AND OUTSIDE
BODY LIQUID COMPARTMENT
60% BW CONSIST OF WATER
EXAMPLE:
HORSE BB 500 KG 300L
DOG BW 20 KG 20 L
BODY LIQUID IS ENDED:
INTRA CELLULAR (CIS) 40% BB
EXTRA CELLULAR (CES) 20% BB
EXTRA CELLULAR LIQUIDS
INTERTITIAL LIQUID 15% BB
INTRA VASCULAR LIQUIDS (PLASMA) 5% BB
LIQUID TRANS-CELLULAR LIQUID GASTROINTESTINAL DUCT
ELECTROLY CONTENT
KATION ANION
CIS K+, Mg++, Na+ HPO4-, PROT-.,
HCO3-, Cl-
CES Na+, Ca++, K+,
Mg++
Cl-, HCO3-,
PROT-, As.Org-,
HPO4-, SO4-
C.INTRAVASK Na+, Ca++, K+,
Mg++
Cl-, HCO3-,
PROT-, As.Org-,
HPO4-, SO4-
BODY LICENSE BALANCE
IN OUT
Sensible Gain:
Drinks
Food
Insensible Gain:
Metabolism
Sensible Loss:
• Urine
• Feces
Insensible Loss:
• Respiratory
• Sweat
SYSTEM OF BODY LIQUIDS
AND ELECTROLYTE
1. THERMOREGULATOR
(HIPOTHALAMUS)
AND SECRETION VASOPRESIN.
2. HORMONAL
HORMON ANTIDIURETIK (ADH)
ALDOSTERON
DISORDERS OF LIGHT
BALANCE
A. INTERRUPTION VOLUME
B. OSMOLARITAS DISORDERS
C. COMPOSITION DISORDERS
D. DISTRIBUTION DISORDERS
OSMOLALITAS DAN
OSMOLARITAS
OSMOL(OSM) : OSMOTIC UNIT ACTIVITY
OSMOLARITAS IS THE TOTAL NUMBER OF
OSMOL PER LITER SOLUTION
OSMOLALITAS IS THE TOTAL NUMBER OF
OSMOL PER KILOGRAM WATER
OSMOLALITAS AND
OSMOLARITAS
ISOSMOTIK: its osmolarity is equal to
body fluids.
NaCl 0.9%, Glucose 5%, Urea 1.74%
ISOTONIK: its osmolarity is same with liquid
body and can maintain body cell volume.
NaCl 0.9%, Glucose 5%.
HYPOTHOTICS: osmolaritas lar <body fluids
NaCl 0.45%
HYPERTONIC: lar osmolaritasnya> body fluids
NaCl 1.5%
INTERRUPTION VOLUME
AND OSMOLARITYEspecially at CES, divided into:
1. Dehydration Volume
* Isotonic: diarrhea, vomiting, blood loss,
Burns.
water deficiency and NaCl.
* Hypotonic: excessive sweating.
Na deficiency
* Hypertonic: Diabetes Mellitus polyuria
INTERRUPTION VOLUME
AND OSMOLARITY
2. Overhydration / Hyperhydration:
Isotonic: Oedema
Hypotonic: excessive amount of water
giving free electrolyte infusion
Hypertonic: Na extracellular >>; because of
adrenal cortex hyperfunction
COMPOSITION DISORDERS
Occurs when there is / concentration of
one or several kinds of electrolytes in the
body fluids. Ex:
K - Hipokalemi
K - Hiperkalemi
Na - Hypernatremia
Gluc - Hypoglycemia
DISTRIBUTION DISORDERS
Stockpiling of Liquids at:
A. Pulmonary membrane Hydrothorax
B. lining Ascites Abdominal
C. Jar. Certain Udema
BALANCE ACID-BASES
Hydrogen ion concentration (H +) at CES
± 40 nmol / L, pH 7.4 (7.35-7.45)
Enzymatic reactions need optimum pH
Perub. The concentration of H + ions affects
the biological processes and metabolism in
the body
DEFINITION pH
pH is a negative logarithm of the hydrogen ion concentration.
pH = - log[H+]
When the blood hydrogen concentration increases then the pH goes down acidosis
When the blood hydrogen concentration falls then the pH rises alkalosis
ACID BASIC SETTINGS
1. BUFFER SYSTEM (BUFFER)
2. RESPECT SYSTEM
3. KIDNEY
RESERVATION SYSTEM
Fast work serves to capture or release H + so that it can minimize the concentration of hydrogen ions.
Body buffer capacity includes:
* Extracellular buffer: bicarbonate buffer and phosphate
* Intracellular buffering: proteins, organic and inorganic phosphates and in Hb.
* Bone: buffer storage area.
BIKARBONAT DISTRIBUTOR
SYSTEMSimilar buffers are most effective because of large enough quantities.
CO2+H2O H2CO3 H+ + HCO3
The Henderson-Hasselbalch Equation:
pH= pK +log [A-]
[HA]
For bikarbonat :
pH= 6,1 + log [HCO3-]
[H2CO3]
RESPIRATORY SYSTEM
• The function regulates the discharge of Co2 gas
through the lungs.
• CO2 breath fast (hyperventilation)
• CO2 slow breath (hypoventilation)
• Respiratory frequency increased due to:
• * pCO2 increases
• * blood pH down
• * pO2 decreases
RESPIRATORY SYSTEM
The Henderson-Hasselbalch Equation:
pH = 6,1 + log [HCO3- ]
0,03xpCO2
Information :
0.03 = solubility factor of CO2 in plasma
pCO2 = tek. Partial gas CO2 (= 40 mmHg)
HCO3 = 24 mEq / L
GINJAL
Fungsi : meningkatkan ekskresi H+ dan
mengatur reabsorbsi HCO3 Plasma.
Ada 2 mekanisme :
1. Pertukaran H+ dengan Na+.
2. Pertukaran NH4+ dengan Na+.
INTERFERENCE BALANCE
BALANCE
Causative factor :
1. Impaired respiratory function.
2. Impaired kidney function.
3. Abnormal acid-base addition.
4. Abnormal acid-base loss.
PEM. ACID-BASIS
INTERFERENCE LABORATORY
* Sample: ARTERI BLOOD
* Anticoagulants: HEPARIN
* Tool: BLOOD GAS ANALIZER
* Parameters:
-blood pH, normal: 7.4
-pC02, normal: 40 mmHg
-HCO3, normal: 24 mEq / L
HOW TO INTERPRETATION
The Henderson-Hasselbalch Equation:pH =
6,1 + log [HCO3-]
0,03xpCO2
pCO2 = its value is only changed by
Respiratory Factor (Respiratorik)
[HCO3] = its value is changed not because
of the Respiratory Factor (Metabolic).
COMPENSATION
* Compensation is due to the increase
the function of controlling organs to try
returns the pH of body fluids to the pH
normal .
* Compensation is done by:
- Respiratory
- Kidney
* Light Compensated
heavy Uncompensated
ASIDOSIS METABOLIK
* Indicated by a decrease in pH and
bicarbonate (pH <7.4; HCO3)
* Cause:
- Lactic acidosis, ketoacidosis. - Diarrhea
-Pharmaceuticals: salicylate, methanol, - Kidney failure
ethylene glycol, and paraldehyde.
COMPENSATION:
* Response of respiratory compensation with increased ventilation and decreased pCO2
ASIDOSIS RESPIRATORIK
* Indicated by a decrease in pH and
increased pCO2 (pH <7.4; pCO2)
* Cause: decreased effectiveness of alveolar ventilation due to:
- upper bag breath obstruction, pneumonia, pneumothorax and chronic lung obstruction.
- CNS medications eg for anesthesia and sedatives.
* COMPENSATION:
The compensatory response to renal bicarbonate retention (HCO3)
ALKALOSIS METABOLIK
* Indicated by increased pH and
bicarbonate (pH> 7.4; HCO3)
* Cause:
-Loss of excessive H + ions due to vomit; use of mineralocorticoids and diuretics.
-Recency of bicarbonate due to renal failure
-Calcalation contraction
COMPENSATION:
* Respiratory response with hypo-ventilation and increased pCO2
ALKALOSIS RESPIRATORIK
* Indicated by increasing pH and decreasing pCO2 (pH> 7.4; pCO2 )
* Cause: Hyperventilation due to hypoxia due
- pulmonary and cardiac disease (CHF).
disturbance at the center of the breath due to salicylate intoxication and infection with gram-negative bacteria.
psychological-psychological
COMPENSATION:
* Response compensation with decreased bicarbonate through resistance of renal bicarbonate reabsorbtion (HCO3 )
RANGKUMAN
INTERRU
PTION
pH PRIMARY
DISORDERS
COMPENSION
RESPONSES.
Asidosis
Metabolik
HCO3- pCO2
Alkalosis
Metabolik
HCO3- pCO2
Asidosis
Respiratorik
pCO2 HCO3-
Alkalosis
Respiratorik
pCO2 HCO3-
