A Critique of the Parameters Used in the Evaluation of Acid-Base Disorders

DISORDERS of acid–base equilibrium can be caused by primary disturbances in the pulmonary regulation of the concentration of carbonic acid in body fluids, by changes in the concentration of bicarbonate and other buffer anions induced by metabolic disturbances or by some combination of the two. The degree and direction of primary respiratory disturbances can be evaluated by the determination of carbon dioxide tension (pCO2) in the blood, since this quantity is directly proportional to the actual amount of dissolved carbonic acid. For the assessment of metabolic disturbances, Van Slyke and Cullen1 proposed many years ago that the bicarbonate . . .