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April 1957

Respiration and the Regulation of Acid-Base Balance

AMA Arch Intern Med. 1957;99(4):569-572. doi:10.1001/archinte.1957.00260040069007

To understand the nature of disturbances in acid-base balance and the role of respiration in their initiation or compensation, it is necessary first to inquire into the operation of the blood buffer systems. The total "base" cations of the blood, Bt (chiefly Na+ and K+), are distributed among "acid" anions as follows:

where P is protein, A is chiefly chloride, and X includes such things as phosphate, sulfate, and lactate. Now in a given blood subject to changes only in carbonic acid (or pCO2), BA is constant and BX is negligibly small. We therefore concentrate our attention on that part of Bt which is distributed between HCO3— and P—. Let us call this the "buffer base," Bb, and define it as follows:

When carbonic acid is added to such blood, the total buffer base remains constant, but its distribution between HCO3— and

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