ReviewCritical care (London, England)2006
Strong ion difference in urine: new perspectives in acid-base assessment.
Review in Critical care (London, England), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 50 citations in OpenAlex.
- Trial
- Association of electrolyte concentrations with pH of blood and urine of cows with left-sided abomasal displacement.Journal of veterinary internal medicine · 2026Article
- Fluid-induced acid-base variations in postoperative critically ill patients: physiological determinants and renal response.Frontiers in medicine · 2026Article
- Acute renal response to changes in carbon dioxide in mechanically ventilated female pigs.Physiological reports · 2024Article
- Alactic base excess (ABE): a novel internal milieu parameter-its concept and clinical importance.International urology and nephrology · 2024Review
- Urinary Chloride Excretion Postcardiopulmonary Bypass in Pediatric Patients-A Pilot Study.Journal of pediatric intensive care · 2024Article
- Strong ion gap and anion gap corrected for albumin and lactate in patients with sepsis in the intensive care unit.International journal of physiology, pathophysiology and pharmacology · 2024Article
- Reply by ZanellaAmerican journal of respiratory and critical care medicine · 2020Article
- Reducing complexity in acid-base diagnosis - how far should we go?Journal of clinical monitoring and computing · 2020Article
- Urine biochemistry assessment in critically ill patients: controversies and future perspectives.Journal of clinical monitoring and computing · 2017Review
- Non-lactate strong ion difference: a clearer picture.Journal of anesthesia · 2016Article
- Urinary Strong Ion Difference as a Marker of Renal Dysfunction. A Retrospective Analysis.PloS one · 2016Article
- Hydrogen ion concentration and coronary artery bypass graft surgery with and without cardiopulmonary bypass.Journal of cardiothoracic surgery · 2013Observational
- Dilutional acidosis: where do the protons come from?Intensive care medicine · 2009Article
- The Stewart approach--one clinician's perspective.The Clinical biochemist. Reviews · 2009Article
- [Paradigm change due to the Stewart model of acid-base equilibrium? We must not re-learn but continue learning!].Wiener klinische Wochenschrift · 2007Article
- New concepts for bringing urine biochemistry back to clinical practice in the intensive care unit.Revista Brasileira de terapia intensivaArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The plasmatic strong ion difference (SID) is the difference between positively and negatively charged strong ions. At pH 7.4, temperature 37 degrees C and partial carbon dioxide tension 40 mmHg, the ideal value of SID is 42 mEq/l. The buffer base is the sum of negatively charged weak acids ([HCO3(-)], [A-], [H2PO4(-)]) and its normal value is 42 mEq/l. According to the law of electroneutrality, the amount of positive and negative charges must be equal, and therefore the SID value is equal to the buffer base value. The easiest assessment of metabolic acidosis/alkalosis relies on the base excess calculation: buffer base(actual) - buffer base(ideal) = SID(actual) - SID(ideal). The SID approach allows one to appreciate the relationship between acid-base and electrolyte equilibrium from a unique perspective, and here we describe a comprehensive model of this equilibrium. The extracellular volume is characterized by a given SID, which is a function of baseline conditions, endogenous and exogenous input (endogenous production and infusion), and urinary output. Of note, volume modifications vary the concentration of charges in the solution. An expansion of extracellular volume leads to acidosis (SID decreases), whereas a contraction of extracellular volume leads to alkalosis (SID increases). A thorough understanding of acid-base equilibrium mandates recognition of the importance of urinary SID.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.