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pK1' and bicarbonate concentration in plasma.

C T Flear, S W Roberts, S Hayes

    Clinical Chemistry
    |January 1, 1987
    PubMed
    Summary

    The pK1' constant in blood plasma varies significantly, impacting bicarbonate concentration calculations. This variability can lead to substantial errors in clinical blood-gas analysis, affecting patient diagnosis and treatment.

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    Area of Science:

    • Biochemistry
    • Clinical Chemistry
    • Medical Diagnostics

    Background:

    • Accurate determination of blood gas parameters is crucial for clinical decision-making.
    • The pK1' constant is a key factor in calculating plasma bicarbonate concentrations ([HCO3]p).
    • Existing methods may not fully account for the variability of pK1' in different patient populations.

    Purpose of the Study:

    • To investigate the variability of the pK1' constant in human plasma.
    • To assess the impact of this variability on bicarbonate concentration calculations.
    • To evaluate the accuracy of blood-gas analyzers in diverse clinical scenarios.

    Main Methods:

    • pK1' values were measured at 37°C in 443 fresh plasma samples from healthy, seriously ill, and hyponatremic patients.
    • Plasma samples were tonometered, and pCO2 values were calculated.
    • Replicate plasma dilutions were analyzed with controlled ionic strength and varying bicarbonate and sodium concentrations.

    Main Results:

    • Significant variations in pK1' values were observed, exceeding 0.06 in healthy and critically ill individuals.
    • Bicarbonate concentrations calculated using a standard pK1' of 6.1 could exhibit errors of up to +/- 60%.
    • pK1' decreased with increasing [HCO3]p at constant ionic strength and was higher at elevated pCO2 levels.

    Conclusions:

    • The pK1' constant is not a fixed value and exhibits considerable variability in human plasma.
    • Standard pK1' values used in blood-gas analyzers can lead to significant inaccuracies in bicarbonate measurements.
    • Clinical interpretations based on calculated bicarbonate levels may require re-evaluation due to pK1' variability.

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