Strong ion difference in urine new perspectives in acid-base assessment 英文参考文献.docVIP

Available online /content/10/2/137 Commentary Strong ion difference in urine: new perspectives in acid–base assessment Luciano Gattinoni1, Eleonora Carlesso2, Paolo Cadringher2 and Pietro Caironi2 1Dipartimento di Anestesia, Rianimazione, e Terapia del Dolore, Fondazione IRCCS – ‘Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena’ di Milano, Istituto di Anestesiologia e Rianimazione, Università degli Studi di Milano, Milano, Italy 2Istituto di Anestesiologia e Rianimazione, Università degli Studi di Milano, Milano, Italy Corresponding author: Luciano Gattinoni, gattinon@policlinico.mi.it Published: 7 April 2006 Critical Care 2006, 10:137 (doi:10.1186/cc4890) This article is online at /content/10/2/137 ? 2006 BioMed Central Ltd Abstract Please note that in the following discussion we will refer to the amount of strong ion difference as SID (mEq), while we will refer to the strong ion difference concentration as [SID] (mEq/l). The plasmatic strong ion difference (SID) is the difference between positively and negatively charged strong ions. At pH 7.4, temperature 37°C and partial carbon dioxide tension 40 mmHg, the ideal value of SID is 42 mEq/l. The buffer base is the sum of negatively charged weak acids ([HCO –], [A–], [H PO –]) and its normal By definition, strong ions are always dissociated in a solution. In plasma, as well as in interstitial fluids, the sum of positively charged ions (primarily Na+, K+, Ca2+ and Mg2+) exceeds the sum of the negatively charged strong ions (primarily Cl– and lactate–) of about 42 mEq/l. This difference is called the SID, and according to the Stewart model [3] its variation is one of the determinants of acid–base status. Looking at Figure 1, the connection between base excess and SID is apparent. The buffer base and SID are equivalent. In fact, because the ideal SID is equal to 42 mEq/l (as is the normal buffer base), it follows tha