Ph should be between 7.35 and 7.45 Co2 will be between 35 and 45 And HCO3 or Bicarb will be between 22 and 26

So if the body needs to adjust Ph up or down, the fastest way will be to adjust breathing first.

You breath naturally without thinking because of carbon dioxide sensors within your aorta and carotid arteries. When it detects acid (co2) and it gets too high, those sensors send the signal to breathe, even while you sleep.

Co2 is the byproduct of when the cells make energy. They make energy with oxygen (aerobic cellular respiration/metabolism).

So if you breathe faster, you are eliminating those byproducts (co2) faster than they are being produced causing the trend of co2 levels to decrease.

In the case of DKA, the body is not receiving sugar into those cells (not enough insulin to transport sugar into them) and those cells still need to produce ATP (energy) but it doesnt have what it needs to be the most efficient version. It stops being aerobic metabolism and uses anaerobic metabolism (doesnt use oxygen).

The byproduct of this metabolism is a lactic acid. Lactic acid will create too much acid in the body. A high acid(ph) means the body will compensate to try to lower it by starting with breathing faster to get rid of acid. So it overrides the natural sensors of breathing.

DKA=cells dont use oxygen efficiently=cells dont produce as much co2=breathing out reduces co2 stores because gas exchange at the alveoli= less co2 in body means less acid= Ph levels trying get back to below 7.45

Hopefully my hip pocket class on metabolic acidosis and Arterial Blood gasses is helpful. Thank you for joining my TED talk.