Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Epidemiology, pathophysiology, and pathogenesis of fetal and neonatal brain injury
- Section 2 Pregnancy, labor, and delivery complications causing brain injury
- Section 3 Diagnosis of the infant with brain injury
- Section 4 Specific conditions associated with fetal and neonatal brain injury
- 22 Congenital malformations of the brain
- 23 Neurogenetic disorders of the brain
- 24 Hemorrhagic lesions of the central nervous system
- 25 Neonatal stroke
- 26 Hypoglycemia in the neonate
- 27 Hyperbilirubinemia and kernicterus
- 28 Polycythemia and fetal–maternal bleeding
- 29 Hydrops fetalis
- 30 Bacterial sepsis in the neonate
- 31 Neonatal bacterial meningitis
- 32 Neurological sequelae of congenital perinatal infection
- 33 Perinatal human immunodeficiency virus infection
- 34 Inborn errors of metabolism with features of hypoxic–ischemic encephalopathy
- 35 Acidosis and alkalosis
- 36 Meconium staining and the meconium aspiration syndrome
- 37 Persistent pulmonary hypertension of the newborn
- 38 Pediatric cardiac surgery: relevance to fetal and neonatal brain injury
- Section 5 Management of the depressed or neurologically dysfunctional neonate
- Section 6 Assessing outcome of the brain-injured infant
- Index
- Plate section
- References
35 - Acidosis and alkalosis
from Section 4 - Specific conditions associated with fetal and neonatal brain injury
Published online by Cambridge University Press: 12 January 2010
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Epidemiology, pathophysiology, and pathogenesis of fetal and neonatal brain injury
- Section 2 Pregnancy, labor, and delivery complications causing brain injury
- Section 3 Diagnosis of the infant with brain injury
- Section 4 Specific conditions associated with fetal and neonatal brain injury
- 22 Congenital malformations of the brain
- 23 Neurogenetic disorders of the brain
- 24 Hemorrhagic lesions of the central nervous system
- 25 Neonatal stroke
- 26 Hypoglycemia in the neonate
- 27 Hyperbilirubinemia and kernicterus
- 28 Polycythemia and fetal–maternal bleeding
- 29 Hydrops fetalis
- 30 Bacterial sepsis in the neonate
- 31 Neonatal bacterial meningitis
- 32 Neurological sequelae of congenital perinatal infection
- 33 Perinatal human immunodeficiency virus infection
- 34 Inborn errors of metabolism with features of hypoxic–ischemic encephalopathy
- 35 Acidosis and alkalosis
- 36 Meconium staining and the meconium aspiration syndrome
- 37 Persistent pulmonary hypertension of the newborn
- 38 Pediatric cardiac surgery: relevance to fetal and neonatal brain injury
- Section 5 Management of the depressed or neurologically dysfunctional neonate
- Section 6 Assessing outcome of the brain-injured infant
- Index
- Plate section
- References
Summary
Introduction
As part of normal homeostasis, the pH of arterial blood is fairly tightly controlled by normal physiologic processes. Healthy adults maintain a reasonably stable pH, ranging from 7.35 to 7.45, and the initial pH after birth can range from 7.11 to 7.36. Acidosis (low pH) and alkalosis (high pH) occur commonly when there are disturbances of the body's normal physiology. This can result from either a pathologic process or medical interventions. When they are due to, or associated with, a pathologic process, the abnormal pH may be blamed for any long-term consequences of that event. Similarly, when a medication or treatment results in an abnormal pH, any long-term consequences may be assigned to that intervention. In both situations, it is not clear whether the underlying physiologic disturbance is responsible for the adverse long-term outcome, or whether the abnormal pH played a role, and if so, how important that role may have been.
Acidosis
Acidosis is known to accompany ischemia, and has been used as a marker for tissue hypoxia and damage. However, it is unclear whether or not acidosis per se is a cause of injury. To examine this issue, we need to separate the two clinical subtypes of acidosis – respiratory and metabolic.
Respiratory acidosis
Respiratory acidosis occurs when carbon dioxide (CO2), produced by metabolism, builds up in the body and dissolves in the bloodstream.
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- Fetal and Neonatal Brain Injury , pp. 402 - 408Publisher: Cambridge University PressPrint publication year: 2009
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