Crit Care Resusc
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Ion selective electrodes (ISE) measure electrolytes by two different technologies, direct and indirect. We wished to investigate the effect of total plasma protein concentration on the plasma sodium, potassium and chloride measurements by indirect ISE compared with measurements by direct ISE. ⋯ The plasma sodium, potassium and chloride measurements are effected by changes in plasma protein concentration when measured by indirect ISE systems. Clinicians must be aware that differences exist between the ISE technologies and in border-line clinical situations, the direct ISE systems provide a more accurate estimate of plasma sodium, potassium, chloride, anion gap, osmolality and strong ion difference calculations, and should be used for clinical decision-making.