China
Africa
Explore chapters and articles related to this topic
Metabolic Laboratory Data
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Like sodium, chloride is a mostly extracellular electrolyte. Unlike sodium it is an anion, not a cation. Chloride actually accounts for most of the measured anion content in our blood. Our bodies contain about 1.6 g of chloride per kg. An average male has about 112 g of chloride in his body, 90% of which is extracellular.
Micronutrients
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Chloride is found in the form of anion (Cl-) in all organisms and combines with cations like sodium (Na+) or potassium (K+) to form a salt such as sodium chloride (NaCl) or potassium chloride (KCl). After sodium, chloride is the most abundant mineral in the body. Chloride is the principal extracellular and intracellular anion (Cl−) in the body, where it represents 60–70% of the total negative ion content (6, 8, 15–16). Chloride is vital for maintenance of serum electrical neutrality, muscular activity, osmotic pressure, electrolyte balance, acid-base status, renal function, regulation of body fluids (fluid homeostasis), and hydrochloric acid (HCl) production in the gastrointestinal tract (6, 8, 15–16). In addition, it is an essential component for the assessment of many pathological conditions. It maintains the electrical balance in the nervous system and is involved in intracellular and extracellular transport (8, 15–16).
Peri-operative medicine
Published in Henry J. Woodford, Essential Geriatrics, 2022
Post-operative acute kidney injury can be avoided by appropriate peri-operative fluids. But excessive administration of fluids leading to water, sodium and chloride overload is also a recognised cause of harm. The prescription of fluids is often delegated to the most junior member of the clinical team. Post-operative oliguria is a common phenomenon and should not be used alone to judge fluid status, which is best assessed by a combination of factors including trends in pulse and blood pressure, capillary refill and jugular venous pressure. Physiologically balanced solutions (e.g. Hartmann's or Ringer's) should be used in preference to normal saline in most situations. The exception to this is where excess chloride loss is anticipated (e.g. vomiting or gastric drainage). Dextrose saline or 5% dextrose pose a risk of hyponatraemia in older people.20 The aim is to return to normal oral food and fluid intake as soon as possible following surgery.
Associations between serum electrolyte and short-term outcomes in patients with acute decompensated heart failure
Published in Annals of Medicine, 2023
Kai Zhao, Qun Zheng, Jiang Zhou, Qi Zhang, Xiaoli Gao, Yinghua Liu, Senlin Li, Weichao Shan, Li Liu, Nan Guo, Hongsen Tian, Qingmin Wei, Xitian Hu, Yingkai Cui, Xue Geng, Qian Wang, Wei Cui
A total of 5145 participants (58.3% men; median age 69 y) comprised the potassium-related study population, with 631, 1784, 1726, 720 and 284 patients classified as internal 1 (K: <3.50 mmol/L), internal 2 (K: 3.50–4.00 mmol/L), interval 3 (K: 4.01–4.50 mmol/L), interval 4 (K: 4.51–5.00 mmol/L) and interval 5 (K: >5.00 mmol/L), respectively. Meanwhile, the sodium-related study population (58.3% men; median age 69 y) included 5135 participants categorized into five groups according to their serum sodium levels. Furthermore, 4966 patients from the chloride-related study population (58.0% men; median age 69 y) were divided into four different groups based on their serum chloride concentrations. Finally, differing from the above, the STC-related study population (58.7% men; median age 68 y) was composed of 4143 patients stratified into three groups on the basis of their STC levels.
Assessing accuracy of testing and diagnosis in cystic fibrosis
Published in Expert Review of Respiratory Medicine, 2023
Malina Barillaro, Tanja Gonska
In a study combining data of eight phase two and three clinical studies examining the effect of the CFTR-modulator, ivacaftor, a significant correlation was observed between the improved sweat chloride levels and the ppFEV1%, predicted forced expiratory volume in 1 second, a classic lung fucntion parameter [35]. Unfortunately, at an individual level, an association between sweat chloride levels and CF-associated symptoms is lacking. In pwCF, sweat chloride levels were not found to correlate to severity of pulmonary disease [36], nor were changes in sweat chloride levels from the baseline, correlated to improvements in lung function with CFTR modulator drug treatment [37]. Thus, sweat chloride levels provide a robust assessment of the CFTR function, and at a population level associate with symptom severity, but association is limited at the individual patient level.
Thiocyanate toxicity: a teaching case
Published in Clinical Toxicology, 2022
C. James Watson, Daniel L. Overbeek, Gabriella Allegri-Machado, Mark D. Kellogg, Al Patterson, J. Brian McAlvin, Michele M. Burns
This case presented several laboratory abnormalities [14,16–18,22]. Pseudohyperchloremia is the most commonly reported laboratory interference in thiocyanate toxicity, especially as measured by ion selective electrodes (ISE) [18,22]. In our case, interference with chloride and other analytes were observed with WB gas analyzer measurements at the tertiary center (ABL800 FLEX, Radiometer, California, USA). Chloride values were repeatedly elevated (113–148 mmol/L) or not reported due to instrument error flags, including “above measurement range” (reported in the medical record as “>350 mmol/L”) and “unstable measurement signal.” Interestingly, plasma samples from the patient measured by ISE-dependent Cobas c501 (Roche, Basel, Switzerland) showed niether pseudohyperchloremia nor other interferences. This may be explained by the fact that plasma samples are measured by an indirect-ISE method (using 31 dilutions before analysis), therefore reducing the amount of interferent (thiocyanate) present on the electrode. Although earlier reports on thiocyanate interference were described in plasma [16,18,22], those reports are from the late twentieth century, suggesting that the modern electrodes used on the c501 are more robust than those previously described.