{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:50:35Z","timestamp":1791960635067,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009553","name":"Agentura Pro Zdravotnick\u00fd V\u00fdzkum \u010cesk\u00e9 Republiky","doi-asserted-by":"publisher","award":["NW26\u201001\u201000360"],"award-info":[{"award-number":["NW26\u201001\u201000360"]}],"id":[{"id":"10.13039\/501100009553","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The strong ion difference (SID) is assessed to interpret acid\u2013base disorders, yet measured plasma values are influenced by electrolyte redistribution across compartments. Current models focus on pH\u2010dependent plasma\u2010erythrocyte shifts. Here, we aim to quantify the effects of hemoglobin oxygen saturation (sO\n                    <jats:sub>2<\/jats:sub>\n                    ). We induced oxygenation and decarboxylation of human venous blood (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200920) via room\u2010air equilibration. We modeled the contribution of \u2206sO\n                    <jats:sub>2<\/jats:sub>\n                    to plasma\u2010erythrocyte shifts through the Haldane effect and hypothesized that combining sO\n                    <jats:sub>2<\/jats:sub>\n                    \u2010 with pH\u2010dependent mechanisms would allow accurate prediction of redistribution related \u2206SID. After room\u2010air equilibration, sO\n                    <jats:sub>2<\/jats:sub>\n                    fraction increased by 0.46 [0.39\u20130.54], CO\n                    <jats:sub>2<\/jats:sub>\n                    tension decreased by 29 [25\u201332] mmHg, and pH increased by 0.25 [0.19\u20130.32]. SID decreased by 5.3 [4.2 to 5.6] mEq\/L, and its changes were independently associated with \u2206sO\n                    <jats:sub>2<\/jats:sub>\n                    (\u2206SID\/\u2206sO\n                    <jats:sub>2<\/jats:sub>\n                    \u2009=\u2009\u22123.0 [\u22125.4 to \u22120.67] mEq\/L,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Accordingly, when only pH\u2010dependent redistribution was considered, \u2206SID prediction yielded a \u2206sO\n                    <jats:sub>2<\/jats:sub>\n                    \u2010dependent (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01) underestimation of measured \u2206SID (mean bias [limits of agreement]: \u22121.6 [\u22123.7 to 0.5] mEq\/L). Including sO\n                    <jats:sub>2<\/jats:sub>\n                    \u2010dependent effects improved the bias (\u22120.4 [\u22122.0 to 1.3] mEq\/L) and removed its \u2206sO\n                    <jats:sub>2<\/jats:sub>\n                    \u2010dependence (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.63), and this result was maintained using a simplified model (\u2206SID\u2009=\u20091.5\u00b7[Hemoglobin+Albumin]\n                    <jats:sub>g\/dL<\/jats:sub>\n                    \u00b7\u2206pH+[Hemoglobin\/4]\n                    <jats:sub>g\/dL<\/jats:sub>\n                    \u00b7\u2206sO\n                    <jats:sub>2<\/jats:sub>\n                    ). We conclude that \u2206sO\n                    <jats:sub>2<\/jats:sub>\n                    independently affects \u2206SID during blood oxygenation and decarboxylation. Incorporating sO\n                    <jats:sub>2<\/jats:sub>\n                    \u2010 alongside pH\u2010dependent electrolyte shifts enables accurate prediction of redistribution\u2010related \u2206SID.\n                  <\/jats:p>","DOI":"10.14814\/phy2.71118","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:38:07Z","timestamp":1790735887000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantifying the effects of hemoglobin saturation on plasma strong ion difference during blood oxygenation and decarboxylation"],"prefix":"10.14814","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0145-5125","authenticated-orcid":false,"given":"Lorenzo","family":"Giosa","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Krbec","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3340-1993","authenticated-orcid":false,"given":"Jakub","family":"Halam\u00edk","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Bolnberger","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital  Prague Czech Republic"},{"name":"Department of Anaesthesia, Intensive Care and Pain Medicine, Medical Clinical Division of General Anaesthesia and Intensive Care Medicine Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Busana","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University Medical Center of G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Brusatori","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tue","family":"Diemer","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren R.","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"},{"name":"Department of Clinical Biochemistry Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micah L. A.","family":"Heldeweg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital  Prague Czech Republic"},{"name":"Department of Anesthesiology Amsterdam University Medical Centers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Zadek","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milan\u2010Bicocca  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E.","family":"Rees","sequence":"additional","affiliation":[{"name":"Institute for Health Science and Technology Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franti\u0161ek","family":"Du\u0161ka","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1914.sp001659"},{"key":"e_1_2_14_3_1","volume-title":"C46\u2010A2: Blood Gas and pH Analysis and Related Measurements; Approved Guideline","author":"Clinical & Laboratory Standards Institute","year":"2009"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.91.22.10517"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1975.sp011043"},{"key":"e_1_2_14_6_1","first-page":"713","article-title":"Serum proteins and acid\u2010base equilibria: A follow\u2010up","volume":"120","author":"Figge J.","year":"1992","journal-title":"The Journal of Laboratory and Clinical Medicine"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-1716.1966.tb03423.x"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05695-x"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-024-07656-5"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00917.2023"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00083.2023"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9258(19)69225-2"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9258(18)85225-5"},{"key":"e_1_2_14_14_1","volume-title":"Pulmonary and Critical Care Medicine","author":"Jones N.","year":"1993"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2026.02.001"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1515\/CCLM.2002.065"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.05.605"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199708000-00016"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2001.91.1.33"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2012.02.011"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1976.40.5.752"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(64)91305-4"},{"key":"e_1_2_14_23_1","volume-title":"The Acid\u2010Base Status of the Blood","author":"Siggaard\u2010Andersen O.","year":"1974"},{"key":"e_1_2_14_24_1","volume-title":"How to Understand Acid\u2010Based Balance: A Quantitative Acid\u2010Base Primer for Biology and Medicine","author":"Stewart P. 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