chloride, adjusted for the absolute difference between sodium and chloride
chloride is arguably the most underestimated quantity in clinical acidbase practice.
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because electroneutrality has to be maintained,
reducing the difference between the two main ions in extracellular fluid
Na+ and Cl-, one positive, the other negative,
necessarily narrows the space left over for the second most common negative ion species: HCO3-.
as long as PCO2 remains unchanged,
the classical Henderson -Hasselbalch- equation tells us that the solution will become more acidotic.
as it is the difference between the two, Na+ and Cl-, that matters
and not their absolute values, Cl- gets adjusted for any concomitant changes in
Na+ by simple addition and subtraction: Clcorr
(deriving Clcorr by the proportional changes, is preferred when looking for concentrational
and dilutional effects.)
consult the glossary for other aspects of acid-base equilibria and the rules and mathematics behind our website:
Glossary