CHLORIDE

• 98 – 106 mmol/L

Chloride is an anion that exits predominantly in extracellular spaces. It maintains cellular integrity through its influence on osmotic pressure. It is also significant in monitoring acid base balance and water balance. Chloride is present in all body fluids but is found in the highest concentrations in the blood

• It works with sodium to maintain serum osmolarity and fluid balance. A shift in sodium and chloride concentration will trigger a fluid volume change to restore normal solute and water ratios. 
• It helps to maintain acid base balance. Chloride has an inverse relationship with bicarbonate which is part of the major chemical buffering system responsible for maintaining a normal pH.
• It helps maintain the balance of extracellular cations /anions and therefore, electrical neutrality.

Chloride measurements are used in the diagnosis and treatment of electrolyte and metabolic disorders such as cystic fibrosis and diabetic acidosis, to help diagnose the cause of s/s such as prolonged vomiting, diarrhea, weakness, respiratory distress.

• When there is suspicion of Acidosis or alkalosis
• When there are symptoms like prolonged vomiting/ diarrhea, weakness, fatigue , Respiratory distress

Hyper chloremia

• Dehydration
• Cushing’s syndrome
• Hyper ventilation
• Eclampsia
• Anaemia
• Cardiac Decompensation
• Renal tubular acidosis
• Mineralocorticoid deficiency
• Hyperparathyroidism

Hypochloremia

• Severe vomiting
• Severe diarrhoea
• Ulcerative colitis 
• Pyloric obstruction
• Severe burns
• Heat exhaustion
• Diabetic acidosis
• Addison's disease
• Fever
• Acute infections such as Pneumonia