Abnormalities of Acid-Base Regulation in Chronic Pulmonary Disease, with Special Reference to Hypercapnia and Extracellular Alkalosis

Abstract

CARBON dioxide retention resulting in an elevation of carbon dioxide tension of body fluids occurs commonly in chronic obstructive pulmonary disease. The hydration of carbon dioxide to carbonic acid leads to an increased concentration of hydrogen ions in body fluids or acidosis. Excess hydrogen ions, so generated, are partially buffered in tissue cells (erythrocytes, bone, muscle and brain) and also result in increased renal hydrogen ion excretion. (It is not clearly established, at present, whether the renal response depends only on increased hydrogen ion excretion, per se, or whether there is enhanced independent tubular bicarbonate resorption, but for descriptive purposes . . .