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Acid–base and blood gases are among the few blood constituents that exhibit substantial difference between arterial and venous values. [6] Still, pH, bicarbonate and base excess show a high level of inter-method reliability between arterial and venous tests, so arterial and venous values are roughly equivalent for these. [44]
As kidney function declines, the tubules lose the ability to excrete excess acid, and this results in buffering of acid using serum bicarbonate, as well as bone and muscle stores. [12] There are many causes of acute metabolic acidosis, and thus it is helpful to group them by the presence or absence of a normal anion gap. [13] Increased anion gap
The calculated value of the anion gap should always be adjusted for variations in the serum albumin concentration. [15] For example, in cases of hypoalbuminemia the calculated value of the anion gap should be increased by 2.3 to 2.5 mEq/L per each 1 g/dL decrease in serum albumin concentration (refer to Sample calculations, below).
The parameter standard bicarbonate concentration (SBC e) is the bicarbonate concentration in the blood at a P a CO 2 of 40 mmHg (5.33 kPa), full oxygen saturation and 36 °C. [13] Reference ranges for blood tests, comparing blood content of bicarbonate (shown in blue at right) with other constituents.
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Base excess is defined as the amount of strong acid that must be added to each liter of fully oxygenated blood to return the pH to 7.40 at a temperature of 37°C and a pCO 2 of 40 mmHg (5.3 kPa). [2] A base deficit (i.e., a negative base excess) can be correspondingly defined by the amount of strong base that must be added.
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