Dueck · Der Anaesthesist 2004 · narrative review · n=?

[Why does blood have a pH-value of 7.4? The theory of acid-base management].

Cited 14 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and theoretical physiological paper without primary empirical data.

PubMed 15565420 · doi:10.1007/s00101-004-0757-2 · record verified 2026-08-30

What was done

This review discusses the physiological principles of acid-base balance and the evolutionary basis for normal arterial pH, focusing on the alpha-stat theory and clinical implications of alpha-stat versus pH-stat management.

What was found

The abstract provides no empirical numbers or quantitative findings. It presents theoretical concepts: arterial pH of 7.40 derives from intracellular pH near neutrality, which optimizes cellular economy because biosynthetic pathway intermediates remain ionized at neutrality, preventing them from diffusing across lipid membranes. The clinical implications of alpha-stat and pH-stat strategies are reviewed.

Why it matters

It outlines the biochemical rationale for the body's homeostatic pH setpoint of 7.40, framing blood acid-base balance around intracellular metabolite trapping and informing management during clinical interventions such as hypothermia.

Limits

This is a theoretical narrative review without primary clinical trials, observational cohorts, or quantitative experimental data.

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