Estudo crítico ao equilíbrio ácido-base, com ênfase à participação iônica, e uma proposta físico-química quantitativa para diagnóstico dos seus distúrbios crônicos

• Autor(a) principal: Martins, Orlando José Ferreira
• Data de Publicação: 1995
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal Fluminense (RIUFF)
• Texto Completo: https://app.uff.br/riuff/handle/1/17904
• topic: Equilíbrio ácido-base; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::PEDIATRIA

The theoretical and practical approach to the acid-base balance in this century has shown different phases. In the beginning, the central idea was the [cations] and [anions] balance. Later, the Henderson-Hasselbach equation and Bronsted-Lowry definitions of acids and bases dominated. The [H+] became the main target, and the flow of protons between donators and receptors substances (acids and bases) the principal event. In this context, the [H+] is also considered a metabolic residual and its excretion, a renal function. A third consideration insinuates trying to recover the [cations] and [anions] equilibrium. The law of the mass action and the principle of electrical neutrality of solutions, are the fundamentals physical-chemical regents. We focused this apparent conflicting points of view, also reviewed some concepts of [H+] transport along the nephron tubules, and the relationship between its flow and the flow of inorganic ions. Several arguments were contested in the classical model, specially, [H+] and [HCO3-] that have a dominant physiological and physiopathologycal position, were dislocated to a secondary levels as dependent variables . From these point, new parameters were suggested to the approach of acid-base balance, ∆[DIF], [A-], ∆[Alb-], ∆pPCO2, that applied to clinical cases, permitted the identification of occult disturbances in the traditional analysis.