Acid-base assessment: when and how to apply the Henderson-Hasselbalch equation and strong ion difference theory

Abstract

The Henderson-Hasselbalch equation is probably the most famous equation in biology but is more descriptive than mechanistic. The traditional approach to acid-base assessment using the Henderson-Hasselbalch equation provides a clinically useful and accurate method when plasma protein concentrations are within the reference range. The simplified strong ion approach is a mechanistic acid-base model that can provide new insight into complicated acid-base disturbances. The simplified strong ion approach should be used to evaluate acid-base balance whenever plasma protein concentrations are abnormal.

Keywords: Acidosis; Alkalosis; Anion gap; Strong ion gap; Total CO(2).