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Detail of measurement chamber of a modern blood gas analyzer showing the measurement electrodes. (Cobas b 121 - Roche Diagnostics) The machine used for analysis aspirates this blood from the syringe and measures the pH and the partial pressures of oxygen and carbon dioxide. The bicarbonate concentration is also calculated.
The magnitude of this difference (i.e., "gap") in the serum is calculated to identify metabolic acidosis. If the gap is greater than normal, then high anion gap metabolic acidosis is diagnosed. The term "anion gap" usually implies "serum anion gap", but the urine anion gap is also a clinically useful measure. [4] [5] [6] [7]
The diagram above can also be used as an alternative way to convert any substance concentration (not only the normal or optimal ones) from molar to mass units and vice versa for those substances appearing in both scales, by measuring how much they are horizontally displaced from one another (representing the molar mass for that substance), and ...
Accordingly, measurement of base excess is defined, under a standardized pressure of carbon dioxide, by titrating back to a standardized blood pH of 7.40. The predominant base contributing to base excess is bicarbonate. Thus, a deviation of serum bicarbonate from the reference range is ordinarily mirrored by a deviation in base excess.
A basic metabolic panel measures sodium, potassium, chloride, bicarbonate, blood urea nitrogen (BUN), magnesium, creatinine, glucose, and sometimes calcium. Tests that focus on cholesterol levels can determine LDL and HDL cholesterol levels, as well as triglyceride levels. [6]
The anion gap is calculated by subtracting the sum of the serum concentrations of major anions, chloride and bicarbonate, from the serum concentration of the major cation, sodium. (The serum potassium concentration may be added to the calculation, but this merely changes the normal reference range for what is considered a normal anion gap)
The bicarbonate ion (hydrogencarbonate ion) is an anion with the empirical formula HCO − 3 and a molecular mass of 61.01 daltons; it consists of one central carbon atom surrounded by three oxygen atoms in a trigonal planar arrangement, with a hydrogen atom attached to one of the oxygens.
The estimation was carried out at a constant pressure of carbon dioxide (PCO2 = 40 mm Hg) and varied pH levels of the serum. The bicarbonate concentration in the red cells was calculated using the Donnan ratio for chloride and bicarbonate ions.