The IV Pole Top
The IV Pole Base
Acid-Base Balance Tutorial

by "Grog" (Alan W. Grogono), Professor Emeritus, Tulane University Department of Anesthesiology

Acid-Base Balance Tutorial Home Page

Blue Bar
IntroductionThis Website mixes serious learning with a little fun. Enough: 'An author who speaks about his own books is almost as bad as a mother who talks about her own children' – Benjamin Disraeli. Nov 19th 1873.


The devastating 1952 poliomyelitis epidemic in Copenhagen (Danish: København) demonstrated the critical need for accurate acid-base assessment. About 3,000 people were infected, of whom roughly one in ten had respiratory paralysis due to bulbar poliomyelitis and about one in hundred died. 1,500 medical and dental students provided 24-hour manual ventilation which saved about 100 lives (Berend 2018). This disaster is summarized in greater detail in the History Section


This tutorial was completely rewritten in March 2018 with new text, diagrams, fonts, and colors. It explains clinical acid-base balance and features a Revised Interactive Acid-base Diagram that now displays typical clinical disturbances in both Metric and US Units. Click on the small icons and diagrams throughout the website to get additional information – sometimes serious, sometimes light-hearted! The website focuses on the Unfortunate Historical Decisions whose legacy still complicates this subject.

Blue Bar

The Bird's Eye-View, Two Components:

Blue Bar

Why do we care?

Heart "Are they diseases themselves?"

Variations in pH or PCO2 used to be thought of as pathological entities. Experiments by Xu et al have shown, however, that very low pH and very high PCO2 may both be well tolerated when circulation and oxygenation are maintained. The implication is that abnormal levels of PCO2 or pH are best regarded as indicators of serious trouble, but not as pathology in themselves.

Getting Started

History "Better start somewhere!"

History, Physiology, and the Interactive Diagram are all good places to start.
Alternatively, use the Index to select the topic that interests you most.

Interactive Acid-Base Diagram

Diagram "Interactive – like a game!"

The Acid-Base Diagram is a Major Feature of this website. It shows characteristic zones on an interactive diagram and simultaneously provides continuous text interpretation. In addition to showing the Classical Zones, it also allows Self Testing.

Blue Bar

Computing Techniques

Computer "Explained as simply as possible!"

The mathematics and programming underlying the interactive diagrams and equations are described on separate pages. This site employs Javascript, and Pop-Ups. To get the best out of this website, these must be active.


Mail "Correspond, touch, associate, connect." Contact me if you wish. I appreciate receiving your feedback, especially if you have ideas comments or suggestions, or if you find errors or spelling mistakes. Thank you.

Blue Bar

Peer Reviewed by AAMC MedEdPORTAL

Med Ed Portal Peer-reviewed successfully by:
MedEdPORTAL. Number: 402.
Subsequent Revisions: Minor corrections only.
Blue Bar

It is My Pleasure to Acknowledge and Thank:

Blue Bar

Same Author:

Animated Knots by Grog
Animated Napkins by Grog
Stereo Art
Magic Squares

About the Author:

Blue Bar
Acid-Base Tutorial
Alan W. Grogono
Small Logo Copyright Mar 2018.
All Rights Reserved
Blue Bar