Acid-base balance and respiration.

The subject of acid-base balance has become one of increasing complexity over the past two decades. Along with better understanding of the processes involved has come an array of confusing terms and ideas that leaves most physicians completely bewildered. For example, in a recent article on acid-base balance, the author listed six commonly used chemical definitions of the words "base" and "acid." ' For the past few years there has been a running international controversy carried on in the pages of Lancet and The New England Journal of Medicine, which has been dubbed The Great TransAtlantic Acid-Base Debate. This debate has mostly dealt with methods and terminology of acid-base chemistry. I hope you will, therefore, understand my reluctance in becoming too involved with semantics, various techniques, and complicated chemistry, and permit me to limit this discussion to basic principles. However, I would admonish you to learn as much as you can about acid-base balance, since we in anesthesia are exposed to these problems more often than those in most other fields of medicine.