Use of Bicarbonate Values

Kenneth M. Riff, MD
Arch Intern Med. 1980;140(3):440. doi:10.1001/archinte.1980.00330150154039.
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To the Editor.  —I read with dismay the recommendations and conclusions of Brashear et al in their article entitled "Relationship Between Arterial and Venous Bicarbonate Values" in the Archives (139:440-442,1979), which are totally at odds with their data and reasonable clinical practice.All of the data that they present show an excellent correlation between measured venous bicarbonate and calculated arterial bicarbonate concentrations. Their analysis of 336 specimens showed a calculated arterial bicarbonate of 27.7 ± 5.9 mEq/L vs a measured venous bicarbonate of 28.1 ± 6.4 mEq/L, while their analysis during acute changes in arterial pH showed these two values to be within 0.7 mEq/L of each other in all situations (vs SD of approximately 1.0 mEq/L in each situation).How do Dr Brashear and co-workers therefore conclude that "... the venous CO2 determination should not be substituted in the Henderson-Hasselbalch equation..." when it is virtually identical to the calculated


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