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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

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IMPACT FACTOR 2016: 3.432

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1437-4331
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Volume 46, Issue 1

Issues

Comparative study of calculated and measured total carbon dioxide

Anchalee Chittamma
  • 1Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Somlak Vanavanan
  • 2Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2007-07-30 | DOI: https://doi.org/10.1515/CCLM.2008.005

Abstract

Background: Total carbon dioxide content (TCO2) can be calculated from measured values of pH and pCO2 according to a simplified and standardized form of the Henderson-Hasselbalch equation, or measured directly.

Methods: We assessed the agreement between calculated TCO2 and measured TCO2 using a total of 74 blood samples. Calculated TCO2 was obtained using blood gas analysis of pH and pCO2 in arterial whole blood on a Nova Stat Profile Critical Care Xpress analyzer. Measured TCO2 was determined using a Dimension RxL analyzer on arterial plasma, and was used as the comparative method. Deming regression analysis, correlation coefficients, bias (Bland-Altman method) and Student's t-test were used for statistical analysis.

Results: Deming regression analysis showed a high degree of correlation between calculated and measured TCO2 (r=0.97). The slope (0.96; 95% CI=0.90– 1.02) of the regression line was close to 1 with a positive intercept (2.86 mmol/L; 95% CI=1.44–4.27), and the standard error of the estimate was 0.20 mmol/L. The mean bias was 1.94 mmol/L with a standard deviation of 1.69 mmol/L. The pCO2 values showed a significant effect on calculated TCO2. Most paired differences were within the 95% limits of agreement (−1.45 to 5.33 mmol/L).

Conclusions: Calculated TCO2 determined using blood gas analysis agreed with measured TCO2 and may be used to assess acid-base imbalance. However, clinicians should be cautious if using this calculated value in the critically ill patient.

Clin Chem Lab Med 2008;46:15–7.

Keywords: acid-base imbalance; calculated total carbon dioxide (TCO2); carbon dioxide; critical care; measured TCO2

About the article

Corresponding author: Anchalee Chittamma, Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Bangkok 10400, Thailand Phone: +66-2-201-1336, Fax: +66-2-354-7266,


Received: 2006-12-31

Accepted: 2007-05-08

Published Online: 2007-07-30

Published in Print: 2008-01-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 46, Issue 1, Pages 15–17, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2008.005.

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©2008 by Walter de Gruyter Berlin New York. Copyright Clearance Center

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