KESEIMBANGAN

ASAM-BASA (1)
Sudarno, dr M.Kes.
 KESEIMBANGAN ASAM-BASA merupakan bagian yang penting untuk
mempertahankan mekanisme HOMEOSTATIK tubuh

 Tanpa keseimbangan Asam-Basa sel tidak dapat berfungsi

 Asam dan Basa secara kontinu masuk dalam peredaran darah berasal
dari:
 Makanan  diet tinggi protein (daging,ikan,telur dll): ASAM
diet tinggi sayuran/buah : BASA
- Metabolisme  karbohidrat, lemak, proteinAsam BasaAsam

Walaupun Asam-Basa merupakan komponen yang penting dalam

keseimbangan namun KONSENTRASI dan PENGENDALIAN ion
HIDROGEN (H+) yang akan dibahas pada keseimbangan Asam-Basa
 The body produces more acids than
bases
 Acids take in with foods
 Acids produced by metabolism of lipids and
proteins
 Cellular metabolism produces CO2.
 CO2 + H20 ↔ H2CO3 ↔ H+ + HCO3-
Ion HIDROGEN yang masuk dlm cairan tubuh
berasal dari:

 Asam KARBONAT (H2CO3) + LAKTAT 

metabolisme aerobik dan anaerobik GLUKOSA
 Asam SULFAT  metabolisme ASAM AMINO
 Asam FOSFAT metabolisme
Ribonukleotida/fosfoprotein
 Asam KETON (ketone bodies)  metabolisme
lemak
 Overview of Acid-Base Physiology

Fixed Acids:

 Volatile acids:
 BrØnsted-Lowry Definition
 Acid
A proton donor
 HOH + HCl (aq) Cl + H2O

H H +
Cl H + O HO + Cl
H H
acid base conjugate acid conjugate base

 Base
A proton acceptor

 HCL + NaOH (aq) NaCl + H2O

 Acid-Base Balance

 Acid is a proton donor. It can be neutral, cationic,

or anionic.

Arrhenius Definition
 Molecules containing hydrogen atoms that can
release hydrogen ions in solutions are referred to
as an acid.
 An example of an acid is hydrochloric acid (HCL)

HCl (aq) H+ + Cl-

 Acid-Base Balance

 Base is a proton acceptor. It can be neutral,

cationic, or anionic.
 A base is an ion that can accept a hydrogen ion.
 An example of a base is is the bicarbonate ion.
( HCO3-)

 When an acid releases a proton, it is converted to the

conjugate base.
 When a base binds a proton, it is converted to the
conjugate acid.
 Some substances can be either an acid or a base
depending on the environment. (i.e., H2PO4-)
 Acids are H+ donors.
 Bases are H+ acceptors, or give up OH- in
solution.
 Acids and bases can be:
 Strong – dissociate completely in solution

• HCl, NaOH
 Weak – dissociate only partially in solution

• Lactic acid, carbonic acid

 pH and pKa
A molecule, or an atom group in a molecule, may lose or gain a
proton when the molecule is placed in an aqueous solution.

The exact probability that a molecule will be protonated or deprotonated

depends on the pKa of the molecule and the pH of the solution
 pH Review
 pH = - log [H+]
 H+ is really a proton
 Range is from 0 - 14
 If [H+] is high, the solution is acidic; pH < 7
 If [H+] is low, the solution is basic or alkaline ;
pH > 7
 pH
 The unit of the measurement use to discribe
the alkalinity or acidity of a substance is the
pH
 pH stands for the potential of hydrogen
 Measured on a scale 0-14
 Scale represents hydrogen ion concentration
 Acid-Base Balance
 The pH is calculated
by taking the negative
logarithm of the
hydrogen ion
concentration, as
shown below.

 pH = -log10[H+]:
where [H+] is the
hydrogen ion
concentration
 ACID/BASE BALANCE AND THE
BLOOD
[OH -]
[H+]

Acidic Alkaline (Basic)

Neutral
pH
0 7 14
Arterial Blood
Venous Blood

Acidosis 7.4 Alkalosis

Normal 8.0
6.8
7.35-7.45
Normal acid-base balance

Arterial blood pH normally 7.4

Acidosis – pH below 7.35
Alkalosis – pH above 7.45
ie 0.05 pH units above or
below normal
 The Body and pH
 Homeostasis of pH is tightly controlled
 Extracellular fluid = 7.4
 Blood = 7.35 – 7.45
 < 6.8 or > 8.0 death occurs
 Acidosis (acidemia) below 7.35
 Alkalosis (alkalemia) above 7.45
 Small changes in pH can produce
major disturbances
 Most enzymes function only with narrow pH
ranges
 Acid-base balance can also affect electrolytes
(Na+, K+, Cl-)
 Can also affect hormones
 Persamaan Henderson-Hasselbach
HA H+ + A-
CO2 + H2O H2CO3 H+ + HCO3-

 pH = pKa + log [A-]/ [HA]

 pH = pKa + log [HCO3-]/[H2CO3] : 25 mmol/l : 20

 pKa H2CO3 = 6,1 1.25 mmol/l 1

 pH plasma darah = 6,1 + log

= 6,1 + log 20/1 = 7,4
 pH plasma darah = 7,4
 Regulation

The process of acid-base regulation involves:

1. Chemical buffering by intracellular and extracellular

buffers

2. Control of pCO2 by normal respiratory function

3. Control of HCO3- concentration and acid excretion by

the kidney
Acids, Bases and Buffers
 Acids: An acid is defined as any compound,
which forms hydrogen ions in solution. For this
reason acids are sometimes referred to as
"proton donors". To aid understanding of these
concepts consider an imaginary acid with the
chemical formula HA. In the first example in
Figure 2, the acid dissociates (separates) into
hydrogen ions and the conjugate base when in
solution.

 Bases: A base is a compound that combines

with hydrogen ions in solution. Therefore, bases
can be referred to as "proton acceptors".

 Strong Acids: A strong acid is a compound that

ionizes completely in solution to form hydrogen
ions and a base. Example 2 illustrates a strong
acid in solution, where this dissociation is
complete, such as HCl and NaOH.

 Weak Acids and Bases: these are compounds

that are only partially ionised in solution.
Example 3 shows a weak acid in solution with
incomplete dissociation, such as :
 CH3COOH <=> H+ + CH3COO-.
Buffers
 Buffers
 Buffer solutions have the property of showing only small changes of pH when
an acid or base is added, within limits. A buffer solution is prepared by mixing
a weak acid with its conjugate base, i.e. the salt of the acid (e.g. CH3COOH
and Na+CH3COO-). A buffer solution can also be prepared by mixing a weak
base with its conjugate acid.

 If we add NaOH to an acetic acid/sodium acetate buffer solution the following

reactions occur: NaOH => Na+ + OH- completely, then
CH3COOH releases a proton (CH3COOH <=>H+ + CH3COO-)
to neutralize the OH- ions,
producing the reaction OH- + H+ <=>H2O,
and the change in pH will be minimal.

Continuing to add NaOH will produce further dissociation of acetic acid until
the concentration of acetic acid is significantly reduced.
Then addition of more NaOH will have a greater impact on pH.
Adding HCl will have the opposite effect. H+ ions will bind to CH3COO-,
producing the weak acid CH3COOH, minimizing the change in pH.
 Control of Acids

Buffer systems
Take up H+ or release H+ as conditions
change
Buffer pairs – weak acid and a base
Exchange a strong acid or base for a weak
one
Results in a much smaller pH change
 Sistem yang berperan mempertahankan pH
darah ( mekanisme kontrol) adalah
BUFER (Dampar)
Bufer asam-basa adalah larutan dari senyawa kimia yang dapat
mempertahankan perubahan pH yang minimal dalam suatu larutan
bila ditambah basa atau asam

 1. Bufer kimia (asam Karbonat, bikarbonat merupakan

sistem bufer tubuh yang penting walaupun tidak seefisien bufer
fisiologi) & protein/fosfat plasma)
 2. Bufer fisiologi ( paru2 dan ginjal)
 3. Bufer biologi (darah)
 1.BUFER KIMIA
CO2 + H2O H2CO3 H+ + HCO3-

Cairan ekstraseluler normal ratio

[HCO3-]/[H2CO3] : 20/1

Ratio ini menentukan keseimbangan asam-basa pada keadaan

pH : bila pH lebih dari 7.4  ALKALOSIS
kurang dari 7.4  ASIDOSIS
 1.a Bicarbonate buffer
 Sodium Bicarbonate (NaHCO3) and carbonic
acid (H2CO3)
 Maintain a 20:1 ratio : HCO3- : H2CO3

HCl + NaHCO3 ↔ H2CO3 + NaCl

NaOH + H2CO3 ↔ NaHCO3 + H2O

 1.b Phosphate buffer
 Major intracellular buffer
 H+ + HPO42- ↔ H2PO4-

 OH- + H2PO4- ↔ H2O + H2PO42-

 2.BUFER FISIOLOGIS

 Bila bufer kimia tidak dapat menstabilkan pH =7.4 maka

dilanjutkan bufer fisiologis sebagai berikut:

a) PARU2
 Apabila pH turun (CO2 meningkat):
 Paru2 berusaha meningkatkan pernafasan

(hiperventilasi)

• Apabila pH naik (CO2 menurun):

- Paru2 berusaha menurunkan pernafasan
(hipoventilasi)
 Peranan sistem pernapasan dalam
mempertahankan PH darah
 Pengeluaran CO2 dari darah dan pasokan O2
pada jaringan adalah fungsi utama sistem
pernapasan
 Sistem pernapasan dikendalikan oleh pusat
pernapasan di otak
 Mekanisme pernapasan dapat dirangsang
oleh turunnya pH, turunnya pO2,
peningkatan suhu dll.
 pH
pO2
Suhu
Respiratory center

Spinal cord

Phrenic nerve (and intercostal

nerves).

Resp. muscles
 2. Respiratory mechanisms
 Exhalation of carbon dioxide
 Powerful, but only works with volatile acids
 Doesn’t affect fixed acids like lactic acid
 CO2 + H20 ↔ H2CO3 ↔ H+ + HCO3-
 Body pH can be adjusted by changing rate
and depth of breathing
 pH

PaCO2
HCO3-
H2CO3 As PaCO2 levels continue increasing,

CO2 accumulates in the body tissues and fluids, including cerebrospinal

fluid and the respiratory center in the medulla.

Like in the blood, the CO2 combines with H2O to form H2CO3,
which in turn dissociates into H+ and HCO3- ions.
HIPERVENTILASI

This increase in CO2 and H+ ions stimulates the respiratory center to

increase the respiratory rate (correction) to excrete the excess CO2 and
bring the pH back into normal range. If correction is successful

increased respiratory rates, perhaps shallow respirations, a decreasing PaCO2 and an increasing pH.
b) Renal (Ginjal)
(mekanisme renal lebih lambat dibanding paru2)

 Apabila pH turun (CO2 meningkat):

 Ekskresi H
+ (NH ) ke urine meningkat
4
 Reabsorpsi Na
+ (sodium) dan HCO3- dari ginjal ke

darah meningkat ( 1 Na+ untuk 1 H + ) mengatur

pertukaran Na+ dan H +
 3. Kidney excretion
 Can eliminate large amounts of acid
 Can also excrete base
 Can conserve and produce bicarb ions
 Most effective regulator of pH
 If kidneys fail, pH balance fails
 *pertukaran Na+-H+
*pembentukan ammonia
*reabsorpsi HCO3-

As respiratory mechanisms (correction) fail,

the increasing PaCO2 stimulates the kidneys to retain

both HCO3- and sodium (NA+) ions and
to excrete H+ (compensation) ions.

The H+ is excreted as free H+ and some as ammonium (NH4).

Meanwhile, the NA+ and HCO3- ions combine to form sodium
bicarbonate (NaHCO3),
Look for a more acidic urine, increasing pH and bicarbonate values, slower (and perhaps
shallow) respirations.
Kidney Regulation of
Acid-Base Balance
 Rates of correction
 Buffers function almost instantaneously
 Respiratory mechanisms take several minutes
to hours
 Renal mechanisms may take several hours to
days
Konsentrasi H+ menggambarkan sebagai pH darah
pH = - log (H+ )
Larutan dinamakan ASAM atau BASA tergantung
dari besar pH

pH darah berkisar : 7.35 – 7.45

 3. Bufer Biologis
 Bufer terakhir adalah bufer biologis yaitu HEMOGLOBIN
Hb+ + H+ H-Hb
 Hb  berperan penting untuk bufer H+ yang dilepas oleh
karbonik anhidrase pada eritrosit
 Protein Buffers
 Includeshemoglobin, work in blood and ISF
 Carboxyl group gives up H+
 Amino Group accepts H+
 Side chains that can buffer H+ are present on 27
amino acids.
 Carbonic anhydrase

CO2 + H2O H2CO3 H+ + HCO3-

Excretion regulated by the kidneys:

Metabolic control

Excretion regulated by the lungs:

Respiratory control
 Komponen gas darah arteri dlm keadaan
NORMAL :

 pH 7.35-7.45
 PaCO2 35-45 mmHg
 HCO3- 18-24 mEq/L
 PaO2 50-80 mmHg
 Enzim karbonik anhidrase
 Enzimini mengandung Zinc
 Mengkatalisis reaksi
CO2 + H2O H2CO3 H+ + HCO3-
 Terdapat pada eritrosit dan pada sel
tubulus ginjal  sumber HCO3-
 Melalui reaksi ini ginjal mengatur kadar
HCO3- plasma dengan cara reabsorpsi dan
sintesis HCO3- , sedangkan eritrosit
mengatur melalui responsnya terhadap
perubahan pCO2
Selamat belajar.
Hydrogen Ion Buffering
Acidosis and Alkalosis