Extracellular Fluid pH Research Articles

Oscillations of medullary extracellular fluid pH caused by breathing

The purpose of this study was to determine if respiratory oscillations of arterial P CO2 are transmitted to the medullary ECF. Anesthetized, paralyzed cats whose vagi and carotid sinus nerves had been cut were studied. A flat surface pH electrode (2 mm in diameter) and a specially built differential amplifier were used to measure pH on the ventral surface of the medulla. Elimination of noise and high sensitivity were obtained by integrating the output from the pH amplifier with a digital voltmeter. We measured ECF pH oscillations that had the same period as the ventilator. The amplitude of the oscillation was about 0.006 unit when the ventilator was slow (< 10/min). The amplitude decreased progressively as the rate was increased and oscillations were usually undetectable at rates above 25/min. Experiments were performed that ruled out mechanical artifact and ventilator-related fluctuations in arterial pressure as being causal. We conclude that oscillations of alveolar CO 2 are transmitted to the brain by the circulation and result in oscillation of ECF pH.

Respiratory effects of carbon dioxide-induced changes of medullary extracellular fluid pH in cats.

Respiratory effects of carbon dioxide-induced changes of medullary extracellular fluid pH in cats.

Changes in brain ECF pH during metabolic acidosis and alkalosis: a microelectrode study.

We used pH-sensitive double-barreled microelectrodes to measure brain extracellular fluid (ECF) pH in anesthetized dogs during isocapnic infusion acidosis (HCl) and alkalosis (Na2CO3) of 45-60 min duration. The diameter of the tips of these electrodes varied from less than 1 to 27 micron and were placed 5 mm below the surface of the parietal cortex. In group I (metabolic acidosis, n = 5) mean plasma and brain ECF pH fell significantly by 0.221 and 0.025, respectively, with changes in brain ECF pH being 11.3% of those noted in plasma. In group II (metabolic alkalosis, n = 5) mean plasma and brain ECF pH rose significantly by 0.170 and 0.049, respectively, with changes in brain ECF pH being 28.8% of those noted in plasma. Mean arterial and sagittal venous PCO2 and cisternal cerebrospinal fluid (CSF) acid-base variables did not change significantly during acid or base infusion. We conclude that during transients of isocapnic metabolic acid-base perturbations ionic gradients exist between brain ECF and CSF and that changes in brain ECF pH measured by microelectrodes follow the changes in plasma pH. These pH changes may play an important role in respiratory adaptations of acute metabolic acidosis and alkalosis.

Effects of respiratory and (isocapnic) metabolic arterial acid-base disturbances on medullary extracellular fluid pH and ventilation in cats

Ventilation is influenced by the brain extracellular fluid (ecf) pH which is sensed by the central chemoreceptors. In the present experiments we have investigated to what extent ventilatory effects of brain ecf pH changes depend on the origin of these pH changes. With this aim we have compared the effects of ‘respiratory’ (via changes in Pa CO 2 ) and ‘metabolic’ (via isocapnic pHa changes) ecf pH changes on steadystate ventilatory activity. Experiments were performed in anaesthetized (both artificially ventilated and spontaneously breathing) cats with cut sinus nerves; medullary surface ecf pH was measured with a glass electrode with a flat pH-sensitive surface. We found that ecf pH changes caused by changes in Pa CO 2 give rise to greater ventilatory responses than the same ecf pH changes caused by (isocapnic) changes in pHa. Moreover, within the pH ranges measured, isocapnic pHecf-ventillatory response lines at higher Pa CO 2 are shifted upwards compared with those at lower Pa CO 2 levels. It was concluded that with the present technique it is impossible to show a unique relation between ecf pH and ventilation.

Cerebral cortical extracellular fluid H+ and K+ activities during hypotension in cats.

Cerebral cortical blood flow, electrical activity, and extracellular fluid (ECF) pH and K+ ion activities were measured in anesthetized cats (0.7% halothane 65% N2O in O2) subjected to hypotension (mean BP 30-32 and 26-28 mmHg), induced by either practolol and trimetaphan (TMP) or practolol and nitroprusside (NTP). Limited blood withdrawal was also necessary to achieve these blood pressure (BP) levels. Cerebral cortical blood flow during hypotension was greater with NTP than with TMP, and hyperemia occurred in the recovery phase after NTP but not TMP. Electrical activity also was maintained better with NTP. ECF K+ increased in five of six TMP experiments but in only one of six NTP experiments. Values of K+ greater than 15 mM were only seen in the TMP group. Release of K+ into the ECF space occurred at values of cerebral cortical oxygen delivery below 3 ml 100 g-1 min-1. ECF K+ partially recovered after the end of hypotension in all except the experiment with the highest value. A progressive and severe cerebral acidosis was seen in all experiments during induced hypotension, and values below pH 6.50 were present at the stage of K+ increase in the ECF space. It is concluded that the ability of cell membranes in the cat's cortex to maintain normal ionic gradients is depressed by hypotension to these levels with TMP, but not with NTP, and that this difference is related to better-maintained oxygen supply values during NTP hypotension.

Acid-Base Disorders and the Kidney

In the normal human body, the extracellular fluid pH of 7.40 is closely protected. Any increase in acidity or alkalinity summons forth three lines of defense, starting immediately with the blood buffers, followed soon by the respiratory system's control of CO2, and finally purged by the renal excretion of the excess acid or base. The complex interrelated processes of the renal responses require a few days to accomplish maximum compensation. We have presented the fundamental principles governing maintenance of the acid-base equilibrium to provide a conceptual framework for understanding the clinical disorders of hydrogen ion metabolism. The somewhat elusive concepts of endogenous acid production and net acid balance have also been reviewed to help reveal the pathophysiology of metabolic acidosis caused by renal tubular acidosis, chronic renal failure, certain infant feedings, and total parenteral nutrition. The development and perpetuation of metabolic alkalosis in relationship to chloride and potassium deficiency have been examined. In the delineation of a clinical acid-base disorder, the clinician must bear in mind the continual interactions of electrolytes and hormonal systems and should be prepared to reevaluate frequently the elected therapy against the changing responses, based on a thorough understanding of physiology. The various types of renal tubular acidosis have manifold facets but the basic understanding of their pathophysiology begins with the concept of the "anion gap," a point of reference that can be used in the differential diagnosis and treatment. In this chapter a number of new causes of type IV renal tubular acidosis--currently considered to be the most common form of renal tubular acidosis--have been pointed out, along with special reference to the mineral, electrolyte, and aldosterone metabolism in the various acidoses and current means of reversing growth failure in the child, especially through bicarbonate treatment. The mechanism of metabolic acidosis in chronic renal failure including metabolic acidosis in children undergoing dialysis and in recipients of kidney transplantation, and its relationships to mineral and electrolyte metabolism have been presented. The pathophysiology of the acidosis related to certain infant formulas and the acidogenic properties of some amino acid solutions employed in total parenteral nutrition have been briefly reviewed. Finally, the metabolic alkalosis seen in a variety of chloride deficiency syndromes, such as Bartter's syndrome and dietary chloride deprivation, has been discussed and a rational approach to evaluation and treatment outlined.

Dynamics of brain extracellular fluid pH and phrenic nerve activity in cats after end-tidal CO 2 forcing

Ventilation is influenced by the interstitial [H +] of the brain. The pHecf, which in turn is determined largely by ventilation (via Pa CO 2 ) is sensed by the central chemoreceptors. In order to investigate the dynamics of both pHecf and neural tidal volume, we measured in cats with cut vagi and sinus nerves the dynamic medullary pHecf changes and the associated changes in integrated phrenic nerve activity after end-tidal CO 2 forcing. The medullary surface ecf pH was measured with a glass electrode with a flat pH-sensitive surface. After CO 2 up-steps, the pHecf changed with a time constant of about 43 sec, after down-steps 30 sec was found. The central time constant of the neural tidal volume response was 50 sec (mode) in both cases, whereas the overall response had a (modal) time constant of 80 sec. The results indicate that pHecf dynamics and the dynamic characteristics of the central neural respiratory organization are about equally important in determining the dynamic neural tidal volume response. It is argued that when Pa CO 2 changes, the dynamic pHecf change is perfusion limited and macroscopically homogeneous within the brainstem. Therefore, in our view it seems that the location of the central chemoreceptors within the brainstem is of minor importance in determining the dynamic neural tidal volume response to Pa CO 2 changes.

Brain extracellular fluid pH and blood flow during isocapnic and hypocapnic hypoxia

Cerebrovascular responses to 30 min of isocapnic hypoxia [arterial O2 partial pressure (PaO2) = 33 +/- 1 Torr; means +/- SE] were examined in eight chloralose-urethan-anesthetized, paralyzed, and artificially ventilated New Zealand White rabbits. Cerebral blood flow (Q) was measured using the radioactive microsphere technique. Vascular resistance (R) was calculated from arterial pressure and Q. Brain extracellular fluid (ECF) pH was measured continuously in the same animals using pH microelectrodes (1- to 2-micrometers tip diameter) placed stereotaxically in the diencephalon. Diencephalon Q increased from 40 +/- 2 to 69 +/- 4 ml . 100 g-1 . min-1 (P less than 0.05) as R decreased (P less than 0.05) after 4-6 min of isocapnic hypoxia. Total brain Q and R changes resembled those of the diencephalon. The ECF pH of the diencephalon increased by 0.016 +/- 0.006 (P less than 0.05) after 1 min of isocapnic hypoxia and remained significantly elevated through the first 20 min of hypoxia. Ten minutes after the return of normoxia Q and R were at control levels, whereas diencephalon ECF pH was 0.043 +/- 0.006 below control (P less than 0.05). Five additional rabbits were prepared as described above then made hypocapnic [arterial CO2 partial pressure (PaCO2) = 21 +/- 0.3 Torr] for 18 min. Diencephalon and total brain Q and R remained at control levels through 12-14 min of hyperventilation, whereas diencephalon ECF pH was elevated by 0.03 +/- 0.006 (P less than 0.05). Hyperventilation was then continued with hypoxic gas to lower PaO2 to 35 +/- 4 Torr for 30 min. Both diencephalon and total brain R decreased (P less than 0.05), with no change in Q after 4-6 min of hypocapnic hypoxia. Diencephalon ECF pH was not significantly different from control throughout the hypocapnic-hypoxic period. We conclude that the early cerebral vasodilation during hypoxia is not mediated by increased brain ECF acidity.

Bicarbonate ion modulation of cerebral blood flow during hypoxia and hypercapnia.

The relative importance of changes in extracellular fluid (ECF) pH in mediating increases in cerebral blood flow (CBF) during hypoxia and hypercapnia was assessed by varying [HCO(-3)]ECF in pentobarbital-anesthetized dogs. Blood flow to one caudate nucleus (CNBF) that was bathed by cerebrospinal fluid (CSF) of varied [HCO(-3)] was compared with CNBF (measured by radiolabeled microspheres) on the contralateral side, which received a normal-[HCO(-3)]CSF perfusate. Raising [HCO(-3)]CSF from 25 to 60 meq/l for 150 min lowered CNBF by 16% and suppressed the slope of cNBF response to hypercapnia by 61% but suppressed the slope of CNBF response to hypoxia significantly less (22%). Lowering [HCO(-3)]CSF to 8 meq/l increased CNBF by 71% and augmented the response to hypercapnia by 126% but did not alter the slope of the response to hypoxia. These data indicate that changes in [H+]ECF can account for the increased CBF during hypercapnia but not for the entire hypoxic response. The increase in lactic acid production that would be necessary to solely account for the increase in CBF during hypoxia is much greater than what has been reported in the literature.

Ventral medullary extracellular fluid pH and blood flow during hypoxia.

Vascular responses of the ventral medulla and total brain to 30-60 min of isocapnic hypoxia (PaO2 = 32 +/- 2 Torr) were examined using radioactive microspheres in anesthetized, paralyzed, and artificially ventilated cats. Ventral medullary extracellular fluid (ECF) pH was measured using pH microelectrodes with tip diameters of 1-2 micrometers. Total brain blood flow (Q) increased significantly from a control value of 53 +/- 8 (mean +/- SE) to 160 +/- 42 ml.100 g-1.min-1 following 30-60 min of hypoxia. Ventral medullary Q increased from 28 +/- 5 to 97 +/- 20 ml.100 g-1.min-1 and ECF pH decreased by 0.15 +/- 0.06 pH U. Q responses are attributable to decreased vascular resistance as arterial pressure remained constant. The sensitivity of the ventral medullary vasculature to isocapnic hypoxia did not differ from that of the brain as a whole. The results show that under the conditions of our experiment, the ventral medullary vascular response to hypoxia is not sufficient to stabilize local ECF pH. The observation of simultaneously reduced pH and increased Q is consistent with a role for ECF H+ in mediating the cerebrovascular response to hypoxia.

The Role of Urea Synthesis in the Removal of Metabolic Bicarbonate and the Regulation of Blood pH

Publisher Summary The rates of reactions, the conformations of macromolecules, the interactions among macromolecules and between macromolecules and ligands of low molecular weight, and virtually everything that exist or occur in a living cell are affected by pH. The maintenance of intracellular pH within a reasonably narrow range should be among the most important and difficult regulatory necessities in living organisms. The problem is particularly acute in microorganisms, with their very large surface/mass ratios. In multicellular animals, the regulation of pH has been generalized and in some sense simplified by transferring it from the individual cells to systemic control systems that stabilize the pH of blood and extracellular fluid. The cells of mammals, for example, have become so dependent on this stabilization of the pH of their surroundings that an increase or decrease of 0.5 pH unit seriously threatens the life of the organism. One of the most important biological advantages of the development of a closed circulation by metazoans is that individual cells are freed from the necessity to produce the machinery needed for the stabilization of pH, osmolarity, and ionic strength against wide external fluctuations and the need to expend large amounts of ATP to effect this stabilization.

Ionic transport mechanisms underlying fluid secretion by the pancreas.

The pancreas is a 'leaky' epithelium and secretes a juice in which sodium and potassium have concentrations similar to those of plasma. The characteristic features of the secretion are its isosmolality and its high bicarbonate concentration. It is the latter that has attracted considerable attention. Secretion in the isolated cat pancreas is directly proportional to the bicarbonate concentration in the nutrient fluid. The ability of the gland to secrete weak acids has led to the view that because of the very different chemical nature of the anions, it is most likely that it is a component common to all buffers, the proton, that is subject to active transport. This is supported by the decrease in pH and the increase in rho CO2 of the venous effluent when secretion occurs and the sensitivity of secretion to the pH of the nutritional extracellular fluid. It is proposed that the cellular mechanisms are as follows: CO2 diffuses into the cell and is hydrated to carbonic acid under the influence of carbonic anhydrase. The bicarbonate ion so formed diffused into the ductular lumen and the proton is transported backwards through the epithelium with a proton pump (Mg2+ -ATPase) provisionally located in the luminal membrane and a hydrogen-sodium exchange carrier located in the basolateral membrane. Energy for the latter process is derived from the sodium gradient between extracellular fluid and cell. This gradient is maintained by a (Na+ + K+)-ATPase also located in the basolateral membrane. Chloride appears to be transported partly through a chloride-bicarbonate exchange mechanism but largely passively together with a large sodium and potassium component through the paracellular pathway. Osmotic equilibrium is likely to occur in the small ductules.

Cerebral blood flow during normocapnic hyperoxia in the unanesthetized pony.

The effect of hyperoxia on cerebral blood flow (CBF) was examined in 12 unanesthetized ponies. CBF was determined using radioactive microspheres, 15 micrometer in diam, durijng inspriation of the following gases: 1) room air (control); 2) 40% I2 in N2; and 3) approximately 100% O2 with 2.2-4.5% CO2 added to maintain isocapnia. CBF did not change from control values during either level of hyperoxia. However, cerebrospinal fluid (CSF) carbon dioxide tension (PCO2) increased during 40% O2 (delta 1.0 Torr) and approximately 100% O2 (delta 2.9 Torr). This rise in CSF PCO2, not due to a change in CBF, may have resulted from a decrease in the CO2 carrying capacity of cerebral venous blood during hyperoxia (Haldane effect). Although respiration did not change during 40% O2, expired minute volume increased 25% during approximately 100% O2 due to an increase in tidal volume. This rise in respiration was not associated with changes in any of the conventional stimuli to breathing (arterial pH, O2 tension, or PCO2 or CSF pH). One possible explanation was that cerebral extracellular fluid pH, in the vicinity of the central chemoreceptors, or cerebral intracellular fluid pH changed in a direction unlike CSF pH. An alternate explanation was that the CO2 in the inspired gas activated CO2-sensitive receptors in the lungs.

RELATIONSHIP BETWEEN CEREBRAL BLOOD FLOW CHANGES AND CORTICAL EXTRACELLULAR FLUID pH DURING CEREBRAL METABOLIC DEPRESSION INDUCED BY ALTHESIN

Baboons anaesthetized with halothane and nitrous oxide in oxygen were given Althesin 0.05 ml kg-1 i.v. Cerebral blood flow (c.b.f.) was measured by an electromagnetic flowmeter and by xenon clearance whilst extracellular fluid (e.c.f.) pH of the parietal cortex was measured with a micro pH electrode. Carotid blood flow (carBF) began to decrease and carotid vascular resistance (carVR) to increase 2.0 s (SEM 0.3) after the slowing of the e.e.g. produced by Althesin, while e.c.f. pH began to change to alkaline 10.5 s (SEM 1.0) after the e.e.g. change. The first statistically significant increase in mean e.c.f. pH occurred 25 s after the Althesin-induced change in the e.e.g. The duration of the changes in carVR and e.c.f. pH were 7 and 5 min respectively. It is concluded that the change in e.c.f. pH cannot have initiated the increase in carVR which followed the cerebral matabolic depression produced by Althesin. The later alkaline shift in e.c.f. pH may, however, have maintained the increased carVR during the duration of cerebral metabolic depression produced by Althesin.

The pathophysiological basis of fluid therapy in small animals.

The principles underlying fluid therapy and their application to some medical problems in small animals are presented. The renal mechanisms which normally regulate the volume, electrolyte concentration and pH of extracellular fluid are reviewed. The major clinical disturbances are considered together with the specific means of correcting them by fluid therapy.

Studies on the Complex Formations of L-Tryptophan or Adenosine with Mercury Compounds in the Artificial Intra and Extracellular Fluids

Complex formation of L-tryptophan (Trp) or adenosine (Ado) with mercuric chloride (MC) or methylmercuric chloride (MMC) was examined in an artificial intracellular fluid (pH 8.0) and artificial extracellular fluid (pH 8.0). 1) A strong complex formation of L-tryptophan or adenosine with mercuric chloride was demonstrated in the artificial intracellular fluid containing oxianions (HPO2-4, HCO-3), while the complex formation in the artificial extracellular fluid was considerably weak, because of the high concentiation (110 mM) of chloride ion in this fluid. 2) Dissociation constants (K) of complexes of [MC·Trp], [MC·trptamine], [MC·indole], and [MC·Ado] were found to be 1.83×10-3M, 7.60×10-4M, 1.22×10-5M, and 2.30×10-2M, respectively, in phosphate buffer (32 mM, pH 8.0). 3) The complex formation of L-tryptophan or adenosine with methylmercuric chloride in the artificial intra or extra cellular fluid was much weaker than that with mercuric chloride.

Control of cerebral vascular smooth muscle during general anaesthesia.

The effects of some general anaesthetics, for example thiopentone, Althesin (alphaxalone + alphadolone) and ketamine, on cerebral vascular smooth muscle are those which would be expected from their metabolic actions. With other anaesthetics, mainly those administered by inhalation, and especially the volatile agents, cerebral blood flow increases in excess of the metabolic activity, which is usually depressed to varying degrees. During general anaesthesia with any of these agents, responses to changes in arterial Pco2 or blood pressure are maintained. Furthermore, when seizure activity occurs during enflurane administration, there is a flow response to the associated metabolic stimulation. The time course of the flow response to the metabolically depressant drug Althesin has been measured in baboons and shown to be very rapid. Wtih this drug cerebrovascular resistance begins to increase within 2 s of its arrival in the brain. This rapid flow change occurs also after sympathetic denervation. Extracellular fluid pH of the cortex does not alter until after the initiation of the vascular smooth muscle response.

The pH of brain extracellular fluid in the cat.

1. The blood supply to the medulla was determined by the injection of indian ink via the vertebral arteries. Virtually the whole medulla was supplied by penetrating vessels from the ventral surface. The highest density of small arterioles and venules was found close to the roots of XII and on the ventrolateral surface.2. The pH of extracellular fluid (pH(e.c.f.)) was measured with pH microelectrodes of tip size 1-3 mum in cortex and medulla in seventeen cats, anaesthetized with pentobarbitone or a chloralose-urethane mixture. Parallel measurements were made of the pH of c.s.f. and plasma, the DC potential between plasma and brain and ventilation or phrenic nerve discharge.3. In the majority of tests under steady conditions, the pH of e.c.f. was found to be lower than that of c.s.f. by between 0.03 and 0.08 units. No systematic pH gradients could be found to a depth of 5 mm beneath the surface of either medulla or cortex.4. When plasma P(CO2) was altered, pH(e.c.f.) changed with a latent period and speed of response related to the density of blood vessels. In vascular areas of the medulla and in the cortex, the latent period of 4 sec and the change of pH(e.c.f.) coincided with changes in ventilation. Changes in pH(c.s.f.) over the same areas were invariably slower.5. CO(2) buffering capacities were in the order plasma > e.c.f. > c.s.f. Typical values were respectively, -2.2, -2.1 and -1.6.6. The pH of e.c.f. was unaffected by the intravenous injection of H+ and only slowly by the injection of HCO(3)-. Only up to a depth of 1 mm beneath the surface was pH(e.c.f.) affected by superfusion of mock c.s.f. in the range 6.8-8.0 units. This response had a latent period of 2-3 min and was complete in 15 min.7. The pH of e.c.f. fell with hypoxia after a latent period of > 1 min and if all vasosensory nerves had been cut, pH(e.c.f.) was markedly affected by changes of blood pressure.8. These results indicate that even under steady conditions, the pH of e.c.f. and c.s.f. is not identical, that pH(e.c.f.) is more obviously affected by changes in P(a, CO2) than pH(c.s.f.) and that putative H+ sensors which drive respiratory neurones are likely to be similarly affected.

Weak acid accumulation in the serosal extracellular compartment of the frog gastric mucosa

The dimethyloxazolidine dione distribution in the extracellular compartments of the frog gastric mucosa was analyzed by washout kinetics. The volumes of the two extracellular compartments, serosal and mucosal, were estimated by inulin washout as 0.435 ± 0.019 and 0.176 ± 0.018 μl/μl tissue water, respectively. In the serosal extracellular space, significant dimethyloxazolidine dione accumulations of 2.63 ± 0.25, 2.28 ± 0.16, and 1.86 ± 0.08 times that of the bathing media were found for bathing solutions with pH values of 6.9, 7.4, and 7.9 respectively. A high pH of the serosal extracellular fluid by itself could not account for the high values of dimethyloxazolidine dione accumulation. A difference in the total dimethyloxazolidine dione accumulation requires: (a) the existence of differences in the pH values and also the existence of a difference in the diffusion coefficient of the two forms of dimethyloxazolidine dione; or (b), a binding of one of the two forms, i.e., binding of dimethyloxazolidine dione form by fixed charges.

Analysis of vasoactivity of local pH, PCO2 and bicarbonate on pial vessels.

The mechanism by which the local effect of CO2ON pial arterioles is exerted was examined in anesthetized cats equipped with a cranial window for the direct observation of the microcirculation of the parietal cortex. The dilation of pial arterioles in response to application of artificial cerebrospinal fluid with low pH was the same whether or not the PCO2 of the solution was maintained in the normal range or markedly increased. The constriction of pial arterioles in response to application of artificial cerebrospinal fluid with high pH was the same whether or not the PCO2 of the solution was maintained in the normal range or markedly decreased. Finally, pial arterioles did not change their caliber in response to application of cerebrospinal fluid with unchanged pH but markedly increased or decreased Pco, or bicarbonate ion concentration. These results show that the action of CO2 on cerebral vessels is exerted via changes in extracellular fluid pH and that molecular CO2 and bicarbonate ions do not have independent vasoactivity on these vessels.