Reducing complexity in acid-base diagnosis - how far should we go?

摘要: Purpose: To place in context the potential value of isolated plasma strong ion difference (SID) calculations and gap (SIG) versus suggested cut-down versions such as SIDa adj BICgap respectively. Methods: Stewart’s physical chemical approach is seen a mathematical model not displacing traditional Copenhagen Boston approaches. Scanning tools for unmeasured ions based on Principle Electrical Neutrality SIG albumin adjusted anion are evaluated accuracy clinical usefulness. Results: Plasma SID abbreviations independent variables vivo since they vary with PCO due to Gibbs Donnan traffic. They can also exhibit positive negative bias, values must be partnered non-volatile weak acid concentrations when evaluating metabolic acid-base status. The calculation cut down version fixed pH 7.4. It includes phosphate but otherwise similar form corrected gap, sensitivity specificity characteristics. Conclusions: Clinicians unlikely find or clinically useful. current use easily determined by mental arithmetic from point care printouts plus recent measurements. Any slight advantage would offset complexity its calculation.