SERUM ELECTROLTES have the main and basic role on our body in maintaining the body fluids homeostasis.

1. SERUM CHLORIDE
& BICARBONATE

2. CHLORIDE ION:
• Major extracellular anion
PHYSIOLOGY:
• maintaining osmolality, blood volumes and electric neutrality.
REGULATION:
• Chloride absorbed in intestinal tract
• Filtered out by glomerulus
• Counter movement with sodium
MAINTANENCE :
Chloride shift ( sodium reabsorption is limited by amount of chloride by
counter current)

3. SIGNIFICANCE OF BODY’S CHLORIDE
• One of the most important of electrically charged minerals is chloride.
• It works with other electrolytes, such as sodium and potassium, to help balance
acids and bases in our body.
• It also helps move fluid in and out of body cells.
• It also helps maintain proper blood volume, blood pressure, and pH of your body
fluids.

4. SOURCES OF CHLORIDE
• Chloride is found in table salt or sea salt as sodium chloride.
• It is also found in many vegetables.
• Foods with higher amounts of chloride include seaweed, rye, tomatoes, lettuce,
celery, and olives.
• Chloride, combined with potassium, is also found in many foods.

5. PATHOLOGY, SERUM CHLORIDE LEVEL:
• Hyperchloremia –when the serum chloride level increases in our body.
• Hypochloremia –when the serum chloride level decreases in our body.

6. HYPER-CHLOREMIA
• Dehydration
• Cushing syndrome:(reabsorption of chloride at renal tubules decreases)
• Severe diarrhea: (Loss of bicarbonate and Compensatory retention of
chloride)
• Pyelonephritis (low serum level of chloride)

7. HYPO-CHLOREMIA
• Dehydration, Excessive vomiting( body fluid loss)hyperchloremia alkalosis
and “Increase plasma bicarbonate”.
• Addison’s disease : Aldosterone decreases, Reabsorption of CL decreases
and Conc. of CL ion decreases.
• Respiratory alkalosis: Elimination of CO2 increase, Blood bicarbonate
conc. Increases and CL ion conc. Decreases.

8. DETERMINATION OF CL-ION :
• Specimen : serum or plasma
METHODS :
 ISE (Ion selective electrode)
 Amperometric coulometric titration
 Colorimetry

9. SERUM CHLORIDE
Reference range :
• Plasma/serum 98-107m mol/L
• Urine 24 hr 110-250 m mol/day ; varies with diet

10. BICARBONATE ION :
• Second most abundant anion in the ECF.
• CO2 comprises HCO3, H2CO3 and dissolved CO2 comprises HCO3
accounting more than 90% of total CO2 at physiologic pH.
• HCO3 diffuses out of the cell in exchange for Cl. ion to maintain ionic
charge neutrality within cell.
REGULATION :
• H2CO3 CO2 + H20 Diffuses back to ECF
CLINICAL APPLICATIONS :
ALKALOSIS :
• Increased HCO3 hence increased CO2
• Secretion of HCO3 increased in urine
ACIDOSIS :
• Increased excretion of H+ into urine
• CO2 decreases in blood

11. DETERMINATIONS OF SERUM BICARBONATE
& METHODS :
• ISE Method :
• ENZYMATIC Method :

12. REFERENCES
• https://www.medicalnewstoday.com/articles/319801.php
• https://courses.lumenlearning
• https://www.uofmhealth.org/health-library/hw6323
• https://www.healthline.com/health/overhydration