How Differences Between Traditional and Alternative Method in Assessing Acid-Base Disturbances

บทคัดย่อ

The maintenance of acid-base balance is crucial for normal physiological functioning, and it is achieved through the interaction of the respiratory system, the renal system, and the buffer system. Acid-base disturbances can be caused by various factors. The traditional method of assessing acid-base status, the Henderson-Hasselbalch equation, is widely used to evaluate simple or mixed metabolic and respiratory acid-base disorders, and it takes into account the partial pressure of carbon dioxide, which is an important factor in the regulation of acid-base balance. However, it has limitations in its ability to evaluate unmeasured anions and cations, particularly in the presence of non-bicarbonate buffers. In contrast, the Strong Ion Difference, is widely used in critical care medicine as it takes into account multiple acid-base disturbances, including changes in unmeasured ions and weak acids. It is more accurate in the presence of non-bicarbonate buffers, such as lactate or albumin, which can contribute to the imbalance. However, it is not useful in evaluating respiratory disorders. Both methods have their assumptions and limitations. Clinicians need to understand the underlying principles, limitations, and potential pitfalls of each to make accurate assessments.