The lungs excrete volatile acid (CO2) by changes in the rate and volume of respiration. This is regulated by respiratory centers in the brainstem that respond to changes in the pH of the cerebrospinal fluid (which is in equilibrium with extracellular fluids elsewhere in the body), and signals from chemoreceptors in the carotid and aortic bodies that are responsive to changes in pH and PCO of the arterial blood (increased PCOz or reduced pH cause an increase in respiration). Thus, acidosis leads to an increase in respiratory rate and ventilatory volume (the pattern in severe acidosis being described as Kussmaul breathing) and alkalosis leads to the opposite effect.

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