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Hyperchloraemic acidosis: another misnomer?

D A Story1

  • 1Joint Coordinator of Anaesthesia Research, The University of Melbourne, Austin Health, Heidelberg, Victoria. david.story@austin.org.au

Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
|March 25, 2006
PubMed
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Hyperchloraemic acidosis is a misnomer in medicine. The acid-base balance is affected by the strong ion difference, not solely by chloride levels, making the term misleading.

Area of Science:

  • Medical Physiology
  • Acid-Base Balance
  • Clinical Chemistry

Background:

  • The term hyperchloraemic acidosis is widely used and taught in medical education.
  • Existing understanding of acid-base physiology often centers on bicarbonate levels.

Purpose of the Study:

  • To critically review the established medical term hyperchloraemic acidosis.
  • To clarify the underlying physiological mechanisms of acid-base disturbances.

Main Methods:

  • Literature review of peer-reviewed articles and reviews.
  • Focus on acid-base physiology and related clinical concepts.

Main Results:

  • Hyperchloraemic acidosis is a misnomer; acidosis is linked to decreased strong-ion difference, not just high chloride.

Related Experiment Videos

  • Plasma sodium concentration influences the presence of acidosis with hyperchloraemia.
  • Acid-base status can be altered with normal or even low chloride levels, or high chloride without acidosis.

    • Conclusions:

    • The term hyperchloraemic acidosis is inaccurate and should be reconsidered.
    • A comprehensive understanding requires considering strong ion differences over isolated chloride measurements.
    • The Stewart approach offers a more accurate framework for understanding acid-base disorders.