Finally, the review examines the potential intensive care unit practice implications of a better understanding of chloride.Ĭhloride is the major strong anion in blood - accounting for approximately one-third of plasma tonicity, for 97 to 98% of all strong anionic charges and for two-thirds of all negative charges in plasma. The paper also highlights current knowledge on the impact of different types of intravenous fluids on chloride concentration and the potential effects of such changes on organ physiology. The present review summarizes key aspects of chloride physiology, including its channels, as well as the clinical relevance of disorders of chloraemia. It has also indirectly helped to generate interest in other possible effects of disorders of chloraemia. In clinical practice, interest in a physicochemical approach to acid-base physiology has directed renewed attention to chloride as a major determinant of acid-base status. New insights into its physiological roles have emerged together with progress in understanding the structures and functions of chloride channels. Yet chloride has received less attention than any other ion in the critical care literature. Its concentration is frequently abnormal in intensive care unit patients, often as a consequence of fluid therapy. 32: 299–311.Chloride is the principal anion in the extracellular fluid and is the second main contributor to plasma tonicity. Walser M, Seldin DW, Grollman A: An evaluation of radiosulfate for the determination of the volume of the body. Solomon AK: Equations for tracer experiments. Skelton H: The storage of water by various tissues of extracellular fluid in man and dogs. Schultz AL, Hammarsten JF, Heller BI, et al: A critical comparison of the T-1824 dye and iodinated albumin methods for plasma volume measurement. Schultz S: Sodium-coupled solute transport by small intestine: A status report. Ruch TC, Patton HD: Physiology and Biophysics, ed 20. The determination of total body fat by means of the body specific gravity. Rathbun EN, Pace N: Studies on body composition. Chicago, Year Book Medical Publishers, Inc, 1974. Pitts RF: Physiology of the Kidney and Body Fluids, ed 3. The body water and chemically combined nitrogen content in relation to fat content. Pace N, Rathbun EN: Studies on body composition. Manery JF: Water and electrolyte metabolism. Koushanpour E: Renal Physiology: Principles and Functions, ed 1. Greger R, Schlafler E, Lang F: Evidence for electroneutral sodium chloride cotransport in the cortical thick ascending limb of Henle’s loop of rabbit kidney. Goldberger E: A Primer of Water, Electrolytes and Acid-Base Syndrome. Cambridge, Mas, Harvard University Press, 1967. Gamble JL: Chemical Anatomy, Physiology and Pathology of Extracellular Fluid. Am J Med 1959 27: 256–277.įrus-Hansen B: Changes in body water compartments during growth. Metabolism 1954 3: 530–538.Įdelman IS, Leibman J: Anatomy of body water and electrolytes. The normal exchangeable sodium, its measurement and magnitude. Am J Physiol 1952 171: 279–296.Įdelman IS, James AH, Brooks L, et al: Body sodium and potassium. Characteristics of deuterium oxide equilibration in body water. J Clin Invest 1952 31: 197–199.Įdelman IS: Exchange of water between blood and tissues. Chicago, Year Book Medical Publishers, Inc, 1952, vol 5.ĭeane N, Smith HW: The distribution of sodium and potassium in man. Deane N: Methods of study of body water compartments, in Corcoran AC (ed): Methods in Medical Research.
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