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Test Name: Bicarbonate, Blood

Specimen Type: Serum

Specimen Required: 3-5 Cc Yellow Top Gel Vial

Day Performed: Daily

Reporting Time: 8 Hours  STAT Reporting Time: 120 MINUTES

Methodology: Beckman Coulter AU480

CLINICAL SIGNIFICANCE:

Lower-than-normal levels:

  • Addison disease
  • Carbonic anhydrase inhibitors (used to treat glaucoma)
  • Diarrhea
  • Ethylene glycol poisoning
  • Ketoacidosis
  • Kidney disease
  • Lactic acidosis
  • Metabolic acidosis
  • Methanol poisoning
  • Renal tubular acidosis — distal
  • Renal tubular acidosis — proximal
  • Respiratory alkalosis (compensated)
  • Salicylate toxicity (such as aspirin overdose)
  • Ureteral diversion

Higher-than-normal levels:

  • Bartter syndrome
  • Burns
  • Congestive heart failure
  • Cushing syndrome
  • Dehydration
  • Excessive sweating
  • Hyperaldosteronism
  • Metabolic alkalosis
  • Respiratory acidosis (compensated)
  • Syndrome of inappropriate diuretic hormone secretion (SIADH)
  • Vomiting

Delirium may also alter bicarbonate levels.

 

References:

  1. Bansal A. Respiratory acidosis, respiratory alkalosis, and mixed acid-base disorders. In: Johnson RJ, Floege J, Tonelli M, eds. Comprehensive Clinical Nephrology. 7th ed. Philadelphia, PA: Elsevier; 2024: chap 15.
  2. Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 110.
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