The "in vivo" and "in vitro" CO2-equilibration curves of blood during acute hypercapnia and hypocapnia. II. Theoretical considerations

Extracellular pH defense against lactic acid in untrained and trained altitude residents

The assumption that buffering at altitude is deteriorated by bicarbonate (bi) reduction was investigated. Extracellular pH defense against lactic acidosis was estimated from changes (Delta) in lactic acid ([La]), [HCO3-], pH and PCO2 in plasma, which equilibrates with interstitial fluid. These quantities were measured in earlobe blood during and after incremental bicycle exercise in 10 untrained (UT) and 11 endurance-trained (TR) highlanders (2,600 m). During exercise the capacity of non-bicarbonate buffers (betanbi=-Delta[La]. DeltapH(-1)-Delta[HCO3-]. DeltapH(-1)) amounted to 40+/-2 (SEM) and 28+/-2 mmol l(-1) in UT and TR, respectively (P<0.01). During recovery beta (nbi) decreased to 20 (UT) and 16 (TR) mmol l(-1) (P<0.001) corresponding to values expected from hemoglobin, dissolved protein and phosphate concentrations related to extracellular fluid (ecf). This was accompanied by a larger decrease of base excess after than during exercise for a given Delta[La]. betabi amounted to 37-41 mmol l(-1) being lower than at sea level. The large exercise betanbi was mainly caused by increasing concentrations of buffers due to temporary shrinking of ecf. Tr has lower betanbi in spite of an increased Hb mass mainly because of an expanded ecf compared to UT. In highlanders betanbi is higher than in lowlanders because of larger Hb mass and reduced ecf and counteracts the decrease in [HCO3-]. The amount of bicarbonate is probably reduced by reduction of the ecf at altitude but this is compensated by lower maximal [La] and more effective hyperventilation resulting in attenuated exercise acidosis at exhaustion.

Extracellular bicarbonate and non-bicarbonate buffering against lactic acid during and after exercise

Defense of extracellular pH constancy against lactic acidosis can be estimated from changes (Delta) in lactic acid ([La]), [HCO(3)(-)], pH and PCO(2) in blood plasma because it is equilibrated with the interstitial fluid. These quantities were measured in earlobe blood during and after incremental bicycle exercise in 13 untrained (UT) and 21 endurance-trained (TR) males to find out if acute and chronic exercise influence the defense. During exercise the capacity of non-bicarbonate buffers (beta(nbi) = -Delta[La] . DeltapH(-1) - Delta[HCO(3)(-)] . DeltapH(-1)) available for the extracellular fluid (mainly hemoglobin, dissolved proteins and phosphates) amounted to 32 +/- 2(SEM) and 20 +/- 2 mmol l(-1) in UT and TR, respectively (P < 0.02). During recovery beta(nbi) decreased to 14 (UT) and 12(TR) mmol l(-1) (both P < 0.001) corresponding to values previously found at rest by in vivo CO(2) titration. Bicarbonate buffering (beta(bi)) amounted to 44-48 mmol l(-1) during and after exercise. The large exercise beta(nbi) seems to be mainly caused by an increasing concentration of all buffers due to shrinking of the extracellular volume, exchange of small amounts of HCO(3)(-) or H(+) with cells and delayed HCO(3)(-) equilibration between plasma and interstitial fluid. Increase of [HCO(3)(-)] during titration by these mechanisms augments total beta and thus the calculated beta(nbi) more than beta(bi) because it reduces DeltapH and Delta[HCO(3)(-)] at constant Delta[La]. The smaller rise in exercise beta(nbi) in TR than UT may be caused by an increased extracellular volume and an improved exchange of La(-), HCO(3)(-) and H(+) between trained muscles and blood.

Causes of differences in exercise-induced changes of base excess and blood lactate

It has been concluded from comparisons of base excess (BE) and lactic acid (La) concentration changes in blood during exercise-induced acidosis that more H+ than La- leave the muscle and enter interstitial fluid and blood. To examine this, we performed incremental cycle tests in 13 untrained males and measured acid-base status and [La] in arterialized blood, plasma, and red cells until 21 min after exhaustion. The decrease of actual BE (-deltaABE) was 2.2 +/- 0.5 (SEM) mmol l(-1) larger than the increase of [La]blood at exhaustion, and the difference rose to 4.8 +/- 0.5 mmol l(-1) during the first minutes of recovery. The decrease of standard BE (SBE), a measure of mean BE of interstitial fluid (if) and blood, however, was smaller than the increase of [La] in the corresponding volume (delta[La](if+blood)) during exercise and only slightly larger during recovery. The discrepancy between -deltaABE and delta[La]blood mainly results from the Donnan effect hindering the rise of [La]erythrocyte to equal values like [La]plasma. The changing Donnan effect during acidosis causes that Cl- from the interstitial fluid enter plasma and erythrocytes in exchange for HCO3(-). A corresponding amount of La- remains outside the blood. SBE is not influenced by ion shifts among these compartments and therefore is a rather exact measure of acid movements across tissue cell membranes, but changes have been compared previously to delta[La]blood instead to delta[La](if+blood). When performing correct comparisons and considering Cl-/HCO3(-) exchange between erythrocytes and extracellular fluid, neither the use of deltaABE nor of deltaSBE provides evidence for differences in H+ and La- transport across the tissue cell membranes.

The roles of intracellular buffers and bone mineral in the regulation of acid-base balance in mammals

1. Regulation of intracellular and extracellular pH may conflict in their requirements for movement of acid or base. 2. Cells make a positive or a negative contribution to 'tissue buffering' of extracellular fluid (ECF), depending on their internal buffer value, on the tightness of their internal pH control by membrane mechanisms, and on the nature of the acid-base disturbance. 3. A role is suggested for electrogenic Na-HCO3 co-transport in some of the ion shifts that occur in acid-base disturbances. 4. The time course of 'tissue buffering' in nephrectomized mammals in hypercapnia is variable, and it is far from clear in intact, unanaesthetized mammals. 5. Buffering of ECF by Ca salts of bone mineral in acidosis can only be substantial if accompanied by Ca excretion; the release of HCO3 with Na and K is more significant. 6. The relative importance of cells and of bone mineral in the buffering of ECF is unclear.

Bohr shift by lactic acid and the supply of O2 to skeletal muscle

Conditions simulating changes during physical exercise were induced in erythrocytes to determine the resulting Bohr effect. Lactic acid was added to red cell suspensions and whole blood with initial 25 and 60% SO2, at 42 Torr PCO2, and temperatures of 20 and 37 degrees C. Changes in pH, PO2 and SO2 were measured. CO2 liberation from buffering lactic acid in the extracellular fluid and its diffusion into erythrocytes resulted in an exaggerated Bohr shift, if the gas could not escape from the liquid phase (closed system, 'muscle' conditions). PO2 at constant SO2 increased by up to 11.7%.mmol-1.L lactic acid. After reequilibration to initial PCO2 values (open system, 'lung' conditions) the Bohr shift decreased (remaining PO2 increase 0.7-1.4%.mmol-1.L) mainly caused by the reduced acidification. In addition, the Bohr coefficients (BC) under closed conditions were larger (-0.36 to -0.50) than after reequilibration (-0.20 to -0.38). This difference is attributed to a larger CO2 BC than fixed acid BC. These effects might be enhanced in vivo by temperature differences between muscle and lung, lowered nonbicarbonate buffering of blood and counter-current blood flow in muscle.