Medical students, house officers, and practitioners continue to find acid-base metabolism difficult to understand.
Part of that difficulty stems from terminology that is confusing and often misleading. One problem has been that the exact laboratory methods for measuring the various factors used in the evaluation of acid-base disorders have had undue influence on the terminology used in clinical acid-base practice.
One example would be the use of the term blood pH as opposed to blood hydrogen ion concentration. Other articles1,2 have dealt with the controversy of whether to report hydrogen ion activity as pH or as hydrogen ion concentration in nanoequivalents, or nanomoles, per liter (nEq/L or nmole/L). The unnecessary confusion resulting from the use of the aphysiologic terms standard bicarbonate, whole blood buffer base, and base excess has been elegantly reviewed.3
However, another source of confusion in terminology that has not been adequately addressed is the unfortunate