Hypokalemia occurs when the blood plasma level of potassium is too low (below 3.5 mcg). This is the most common electrolyte imbalance. It effects cardiac conduction and function.
Calcium
Calcium is a cation that is stored in the bone, plasma and body cells. In plasma, it binds with albumin. It is well-known that calcium is necessary for healthy teeth and bones. However, it is also necessary for blood clotting, hormone secretion, maintaining the integrity of cell membranes, cardiac conduction, transmission of nerve impulses and muscle contraction. Calcium levels in the body are regulated by bone resorption.
Hypercalcemia occurs when calcium levels rise above 5 mcg in the plasma. One of the most common symptoms is cardiac arrhythmia. X-rays will show calcium loss in the bones when blood plasma levels are high. This is frequently a symptom of and underlying disease with excess bone resorption and the release of calcium. It can be caused by hyperparathyroidism, malignant neoplastic disease, Paget's disease, osteoporosis, prolong immobilization, and acidosis. The most common symptoms presented are anorexia, nausea, vomiting, weakness, and kidney stones.
Hypocalcemia occurs when calcium levels fall below 4.0 mcg. This is often seen in severe illness, after a rapid blood transfusion with citrate, hypoparathyroidism, Vitamin D deficiency, pancreatitis, and alkalosis. Some of the most common symptoms are numbness and tingling, hyperactive reflexes, muscle cramps and pathological fracture.
Chlorine
Chloride, an ion of chlorine is one of the most important compounds that assists with oxygenation of the blood in the lungs. As bicarbonate diffuses into cells, chloride goes from hemoglobin to plasma, causing an anion shift. The lungs will adapt quickly to these changes and will attempt to correct the pH before biological buffers from the kidneys kick in.
Chloride levels that are out of norm typically indicate that the pH is out of balance. When sodium levels are high and bicarbonate levels are low, it typically indicates that a high level of chloride is present. Hypochloremia occurs when the pH rises above 7.45. This condition can lead to excessive vomiting. It can lead to metabolic alkalosis due to reabsorption of bicarbonate. Typically, abnormal chloride levels occur in conjunction with other electrolyte imbalances.
Hydrogen
The lungs alter their depth and rate according to hydrogen concentration. In metabolic acidosis, respiration increases as the body attempts to exhale excess carbon dioxide. In metabolic alkalosis, the lungs attempt to retain carbon dioxide by decreasing respirations.
The carbonic acid-bicarbonate system is the first to respond to ECF changes. It reacts in seconds to regulate the acid-base balance. Increased CO2 leads to increased hydrogen ions. CO2 is excreted by the lungs. We breath faster if it is too high and slower if it is too low. The second system to respond is the biological action of buffers. This system typically responds within 2-4 hours when hydrogen ions are absorbed or released by cells. Hydrogen is positively charged and must change places with another cation, usually potassium. When the ICF pH is low (acid) hydrogen enters the cell and potassium exits the cell and enters the ECF. High K+ leads to diabetic ketoacidosis, a condition that causes cell starvation.
Oxygen
Oxygen is a component of water, which makes up a majority of the human body. Oxygen is necessary for respiration. Oxygen buffers metabolic waste acids by an oxidation reaction. Oxygen prevents the body from becoming too acidic through the build up of acid compounds. Oxygen plays an important role in many reactions within the body. It acts as an intermediary in many processes. It is a by-product of reactions that involve CO2 and water. Oxygen provides the catalyst needed to provide food for the body as well.
Buffers and buffer reactions are one of the most important reactions in the human body. The body has a limited tolerance for changes in pH. The ability to maintain proper pH can present as a primary cause of concern, or it can represent a secondary complication. The most common problem associated with pH shifts are heart arrythmias and pulmonary problems. The six chemicals discussed in this research are the most important ones for maintenance of proper pH. However, there are many others that play a minor role. Understanding how the body maintains homeostasis is one of the most important concepts that any medical professional can know.
References
Levitsky, M. (2007) Pulmonary Physiology. Sixth Edition. New York, New York; McGraw Hill Professional. pp.163-187.
