orrhagic or cardiogenic shock. In such states, glucose metabolism yields lactic acid (pKa = 3.9), which dissociates into lactate and H + , lowering the blood pH. Incomplete fatty acid oxidation occurs in uncontrolled diabetes melli-tus, starvation, and alcoholism and produces ketone body acids (acetoacetic and (P-hydroxybutyric acids). These acids have pKa values around 4 to 5. At blood pH, they mostly dissociate into their anions and H + , making the blood more acidic.

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