{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:58:40Z","timestamp":1784764720499,"version":"3.55.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2007,6,1]],"date-time":"2007-06-01T00:00:00Z","timestamp":1180656000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesth Intensive Care"],"published-print":{"date-parts":[[2007,6]]},"abstract":"<jats:p>\n                    The strong ion gap (SIG) is under evaluation as a scanning tool for unmeasured ions. SIG is calculated by subtracting [buffer base], which is ([A\n                    <jats:sup>-<\/jats:sup>\n                    ]+[HCO\n                    <jats:sub>3<\/jats:sub>\n                    <jats:sup>-<\/jats:sup>\n                    ]), from the apparent strong ion difference, which is ([Na\n                    <jats:sup>+<\/jats:sup>\n                    ] + [K\n                    <jats:sup>+<\/jats:sup>\n                    ]+[Ca\n                    <jats:sup>++<\/jats:sup>\n                    ]+[Mg\n                    <jats:sup>++<\/jats:sup>\n                    ]-[Cl\n                    <jats:sup>-<\/jats:sup>\n                    ]-[L-lactate]). A\n                    <jats:sup>-<\/jats:sup>\n                    is the negative charge on albumin and phosphate. We compared the pH stability of the SIG with that of the anion gap (AG).\n                  <\/jats:p>\n                  <jats:p>\n                    In normal and hypoalbuminaemic hyperlactaemic blood, PCO\n                    <jats:sub>2<\/jats:sub>\n                    was reduced stepwise in vitro from &gt;200 mmHg to &lt; 20 mmHg, with serial blood gas and electrolyte analyses, and [albumin] and [phosphate] measurement on completion.\n                  <\/jats:p>\n                  <jats:p>\n                    Respective [haemoglobin], [albumin], [phosphate] and [lactate] in normal blood were 156 (0.9) g\/l, 44 (2) g\/l, 1.14 (0.06) mmol\/l and 1.7 (0.8) mEq\/l, and in hypoalbuminaemic blood 116 (0.9) g\/l, 24 (2) g\/l, 0.78 (0.06) mmol\/l and 8.5 (0.5) mEq\/l. pH increased from &lt;6.85 to &gt;7.55, causing significant falls in [Na\n                    <jats:sup>+<\/jats:sup>\n                    ] and elevations in [Cl\n                    <jats:sup>-<\/jats:sup>\n                    ]. Initial and final SIG values did not differ, showing no correlation with pH. Mean SIG was 0.5\u00b11.5 mEq\/l. AG values were directly correlated with pH (normal: R\n                    <jats:sup>2<\/jats:sup>\n                    =0.51, hypoalbuminaemic: R\n                    <jats:sup>2<\/jats:sup>\n                    =0.65). Final AG values significantly exceeded initial values (normal blood: 15.9 (1.7) mEq\/l versus 8.9 (1.8) mEq\/l, P&lt;0.01; hypoalbuminaemic blood: 16.5 (0.8) mEq\/l versus 11.8 (2.0) mEq\/l, P&lt;0.05).\n                  <\/jats:p>\n                  <jats:p>We conclude that, unlike the AG, the SIG is not affected by severe respiratory acidosis and alkalosis, enhancing its utility in acid-base disturbances.<\/jats:p>","DOI":"10.1177\/0310057x0703500308","type":"journal-article","created":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T22:45:56Z","timestamp":1548197156000},"page":"370-373","source":"Crossref","is-referenced-by-count":19,"title":["Stability of the Strong Ion Gap versus the Anion Gap over Extremes of PCO\n                    <sub>2<\/sub>\n                    and pH"],"prefix":"10.1177","volume":"35","author":[{"given":"T. J.","family":"Morgan","sequence":"first","affiliation":[{"name":"Department of Chemical Pathology, Mater Health Services, Brisbane, Queensland, Australia"},{"name":"Adult Intensive Care Unit, Mater Health Services."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. M.","family":"Cowley","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology, Mater Health Services, Brisbane, Queensland, Australia"},{"name":"Mater Health Services Pathology."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. L.","family":"Weier","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology, Mater Health Services, Brisbane, Queensland, Australia"},{"name":"Mater Health Services Pathology."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology, Mater Health Services, Brisbane, Queensland, Australia"},{"name":"Intensive Care Units, Princess Alexandra Hospital, Wesley Hospital and University of Queensland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2007,6,1]]},"reference":[{"key":"bibr1-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1016\/0009-9120(90)90588-L"},{"key":"bibr2-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1139\/y83-207"},{"key":"bibr3-0310057X0703500308","first-page":"1","volume-title":"A quantitative acid-base primer for biology and medicine.","author":"Stewart P.A.","year":"1981"},{"key":"bibr4-0310057X0703500308","first-page":"713","volume":"120","author":"Figge J.","year":"1992","journal-title":"J Lab Clin Med"},{"key":"bibr5-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1016\/0883-9441(95)90016-0"},{"key":"bibr6-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8537(05)70015-8"},{"key":"bibr7-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-194805000-00003"},{"key":"bibr8-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-197756010-00002"},{"key":"bibr9-0310057X0703500308","first-page":"155","volume":"6","author":"Morgan T.J.","year":"2004","journal-title":"Crit Care Resusc"},{"key":"bibr10-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199811000-00019"},{"key":"bibr11-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197906213002507"},{"key":"bibr12-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1992.00400200063011"},{"key":"bibr13-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199101000-00038"},{"key":"bibr14-0310057X0703500308","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0102900603"}],"container-title":["Anaesthesia and Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X0703500308","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X0703500308","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:06:19Z","timestamp":1777367179000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0310057X0703500308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,6]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2007,6]]}},"alternative-id":["10.1177\/0310057X0703500308"],"URL":"https:\/\/doi.org\/10.1177\/0310057x0703500308","relation":{},"ISSN":["0310-057X","1448-0271"],"issn-type":[{"value":"0310-057X","type":"print"},{"value":"1448-0271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,6]]}}}