Summary:
The interpretation of acid-base status (simple and mixed disturbances) is made possible by evaluation of three
independent variables: 1. pCO2. 2. The strong ion difference (SID), which is the difference between the sums of
all the strong (fully dissociated, chemically non-reacting) cations and all the strong anions. 3. Non-volatile weak
acids (Atot) are formed by inorganic phosphate and albumin. None of the other acid-base variables, re gularly
presented with acid-base findings (pH, [HCO3 – ] or BE) can change primarily. They are dependent variables and
change only, when one of the independent variable changes.
The paper presents calculations of SID, non-measured anions (UA – ) and the anion gap. The last parameter has
to be corrected for hypoalbuminaemia. Also [Cl – ] has to be corrected in states with hypo- or hypernatraemia.
Examples of various pathological situations and their influence on calculated parameters are presented by means
of model states. The values of measured and calculated parameters in the group of 9 healthy volunteers are
presented also as well as examples of mixed acid-base disturbances from clinical practice.
Key words:
acid-base status, strong ion difference, non-measured anions, anion gap, mixed acid-base distur-
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