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Related Experiment Videos

Discordance between measured and calculated total carbon dioxide.

J P Ungerer1, M J Ungerer, W J Vermaak

  • 1Department of Chemical Pathology, Faculty of Medicine, University of Pretoria, South Africa.

Clinical Chemistry
|December 1, 1990
PubMed
Summary

Accurate measurement of total carbon dioxide (TCO2) is crucial. This study demonstrates that strict pre-analytical control ensures excellent agreement between measured and calculated TCO2, supporting reliable clinical acid-base status evaluation.

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Area of Science:

  • Clinical Chemistry
  • Biochemistry
  • Acid-Base Balance

Background:

  • Conflicting results exist regarding the agreement and correlation between measured and calculated total carbon dioxide (TCO2).
  • Pre-analytical variations are suspected contributors to these discrepancies in TCO2 measurements.

Purpose of the Study:

  • To investigate the correlation and agreement between measured and calculated TCO2 under minimized pre-analytical variation.
  • To assess the impact of sample handling on TCO2 measurement accuracy.
  • To determine if either measurement method can be reliably used for clinical acid-base status evaluation.

Main Methods:

  • Analyzed 88 samples with stringent control of pre-analytical variables.
  • Evaluated 913 routine clinical samples.

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  • Assessed correlation (r) and agreement (standard deviation of differences) between measured and calculated TCO2.

    • Main Results:

    • Excellent correlation (r = 0.98) and small agreement variation (SD = 1.1 mmol/L) were observed in the controlled sample set.
    • Similar results were obtained in a larger set of routine samples.
    • Discrepancies in literature may stem from variations in sample types and handling procedures.

    Conclusions:

    • Rigid control of pre-analytical procedures is essential for accurate TCO2 measurement studies.
    • Both measured and calculated TCO2 methods demonstrate agreement over a wide range.
    • Either method can be reliably employed for accurate clinical acid-base status assessment.