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Related Concept Videos

Diagnosing Acidosis and Alkalosis01:24

Diagnosing Acidosis and Alkalosis

Diagnosing acid-base imbalances involves systematically analyzing arterial blood samples, focusing on three key measurements: pH, bicarbonate (HCO3−) concentration, and carbon dioxide partial pressure (PCO2). This analysis follows a four-step process that helps identify the imbalance's underlying cause and nature.
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2  and HCO3−  values are examined to...
Assessment of Diffusion and Perfusion01:17

Assessment of Diffusion and Perfusion

Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
Bicarbonate-Carbonic Acid Buffer01:22

Bicarbonate-Carbonic Acid Buffer

The carbonic acid-bicarbonate buffer system is critical for maintaining the body's pH balance. It operates on the equilibrium:
Carbon Dioxide Transport in the Blood01:19

Carbon Dioxide Transport in the Blood

Carbon dioxide (CO2) transport in the blood is critical to human physiology. On average, our body cells produce around 200 mL of CO2 per minute, precisely the quantity expelled by the lungs. This process involves the transportation of CO2 from the tissue cells to the lungs in three primary forms.
Forms of CO2 Transport
1. Dissolved in plasma: A small percentage (7-10%) of CO2 is transported and dissolved directly in the plasma.
2. Carbaminohemoglobin: Just over 20% of CO2 is chemically bound to...
Titration of Polyprotic Base with a Strong Acid01:18

Titration of Polyprotic Base with a Strong Acid

The titration of a polyprotic base such as sodium carbonate with a strong acid such as hydrochloric acid results in two equivalence points on the titration curve. At the first equivalence point, the carbonate ions in the base are completely converted to bicarbonate ions. The second equivalence point corresponds to the complete conversion of bicarbonate ions to carbonic acid, which dissociates into carbon dioxide and water. The region before the first equivalence point corresponds to the...
Respiratory Regulation of Acid-Base Balance01:18

Respiratory Regulation of Acid-Base Balance

Respiratory compensation is a vital physiological process that stabilizes blood plasma pH by regulating the partial pressure of carbon dioxide (PCO2), a key determinant of pH levels. Most carbon dioxide in the blood dissolves and converts into carbonic acid (H2CO3). It dissociates into hydrogen ions (H+) and bicarbonate ions (HCO3⁻). There is also an inverse relationship between PCO2​​ and pH.
When carbon dioxide levels increase in the blood, more H+ and HCO3⁻ are produced, leading to a...

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Measuring Carbon-based Contaminant Mineralization Using Combined CO2 Flux and Radiocarbon Analyses
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Comparing measured total carbon dioxide and calculated bicarbonate.

Nadzimah Mohd Nasir1, Pavai Sthaneshwar, Putri Junaidah Megat Yunus

  • 1Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. nadz7nasir@yahoo.com

The Malaysian Journal of Pathology
|July 10, 2010
PubMed
Summary

Measured total carbon dioxide (TCO2) and calculated bicarbonate (HCO3-) showed poor agreement. Clinicians must be cautious when using HCO3- for acid-base disorder management due to this discrepancy.

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Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Acid-Base Balance

Background:

  • Accurate assessment of acid-base balance is crucial for patient management.
  • Total carbon dioxide (TCO2) and bicarbonate (HCO3-) are key indicators in acid-base status.
  • Understanding the agreement between different measurement methods is essential for reliable clinical interpretation.

Purpose of the Study:

  • To evaluate the level of agreement between measured TCO2 and calculated HCO3- in a clinical laboratory setting.
  • To determine if these two parameters can be used interchangeably for patient diagnosis and treatment.

Main Methods:

  • Comparison of TCO2 and HCO3- values from 1820 simultaneously drawn patient samples.
  • TCO2 measured from venous samples using Dimension RxL.
  • HCO3- calculated from arterial blood gas samples analyzed on Radiometer ABL 700.

Main Results:

  • A strong correlation was observed between TCO2 and HCO3- (r = 0.977, p < 0.001).
  • Bland-Altman analysis revealed a bias of 0.87 mmol/L (SD 1.42 mmol/L) with limits of agreement from -1.92 to 3.67 mmol/L.
  • While initial criteria suggested good agreement, further analysis indicated that the methods cannot be used interchangeably, especially at lower values.

Conclusions:

  • Measured TCO2 and calculated HCO3- do not demonstrate sufficient agreement for interchangeable use.
  • A significant discrepancy exists, necessitating caution among clinicians.
  • HCO3- should be used with careful consideration in the management of acid-base disorders.