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Related Concept Videos

Diagnosing Acidosis and Alkalosis01:24

Diagnosing Acidosis and Alkalosis

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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).
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Disorders of Acid-Base Balance01:29

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The human body maintains a precise pH range of arterial blood between 7.35 and 7.45. Deviations result in either acidosis (pH < 7.35) or alkalosis (pH > 7.45). These conditions are further classified as respiratory or metabolic disorders based on their underlying cause.
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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...
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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.
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Assessment of Instrument-Specific Variation between Measured and Calculated Bicarbonate.

Nga Yeung Tang1, Carmen Gherasim2, Lee Schroeder2

  • 1Department of Pathology, University of Illinois Chicago, Chicago, IL, United States.

The Journal of Applied Laboratory Medicine
|January 7, 2026
PubMed
Summary
This summary is machine-generated.

Discrepancies between measured bicarbonate (mHCO3-) and calculated bicarbonate (cHCO3-) can cause diagnostic confusion. This study found good agreement between Radiometer and some chemistry analyzers, but noted bias with Abbott Architect.

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Area of Science:

  • Clinical Chemistry
  • Acid-Base Balance
  • Diagnostic Accuracy

Background:

  • Bicarbonate concentration is crucial for assessing acid-base disorders.
  • Discrepancies between measured (mHCO3-) and calculated (cHCO3-) bicarbonate can lead to clinical confusion and misdiagnosis.
  • Accurate bicarbonate measurement is vital for patient management.

Purpose of the Study:

  • To assess the agreement between calculated bicarbonate (cHCO3-) from a Radiometer blood gas analyzer and measured bicarbonate (mHCO3-) from three different chemistry instruments.
  • To identify potential biases in bicarbonate measurements across different analytical platforms.
  • To improve the reliability of acid-base disorder assessment.

Main Methods:

  • Multi-institutional study involving three different chemistry analyzer manufacturers.
  • Collected de-identified patient data including plasma mHCO3- and blood gas cHCO3- (arterial and venous) within a 20-minute window.
  • Utilized Deming regression and Bland-Altman analysis to determine correlations and biases.

Main Results:

  • Good correlations were observed between cHCO3- and mHCO3- across all platforms.
  • Bland-Altman analysis revealed the greatest bias between Radiometer and Abbott Architect (-2.63 mmol/L).
  • Siemens Advia (0.49 mmol/L) and Beckman AU680 (-0.45 mmol/L) showed minimal bias compared to Radiometer.

Conclusions:

  • This study is the first to compare Radiometer cHCO3- with mHCO3- from multiple chemistry analyzers.
  • Radiometer blood gas analyzer, Siemens Advia, and Beckman AU680 demonstrate good agreement.
  • Abbott Architect may exhibit negative bias in bicarbonate measurements compared to other methods, warranting clinical attention.