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Topic:Lactate

Lactate is a byproduct of anaerobic metabolism, produced when glucose is broken down for energy in the absence of sufficient oxygen. In horses, lactate levels can increase during intense physical exertion, such as racing or other high-performance activities. Elevated lactate concentrations are often associated with muscle fatigue and can provide insights into a horse's exercise physiology and conditioning status. Monitoring lactate levels can aid in assessing the horse's fitness, recovery, and adaptation to training. This page compiles peer-reviewed research studies and scholarly articles that explore the production, regulation, and implications of lactate in equine exercise physiology and performance.
Dietary protein influences acid-base responses to repeated sprints.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 463-467 doi: 10.1111/j.2042-3306.1999.tb05266.x
Graham-Thiers PM, Kronfeld DS, Kline KA.Dietary protein during conditioning and exercise must support additional needs while avoiding adverse metabolic effects. Ten Arabian horses were assigned randomly to 2 diets formulated to contain 7.5 or 14.5% crude protein and 12% fat. The low-protein diet (LP) was supplemented with lysine and threonine to match the levels of these amino acids in the high-protein diet (HP). Feed intake averaged 8.1 kg/day. Dietary cation-anion difference was 181.6 and 260.4 mmol/kg for high and low protein, respectively. Following 9 weeks conditioning, horses performed a repeated sprint test: 3 min walk at 1.5...
Exercise that induces substantial muscle glycogen depletion impairs subsequent anaerobic capacity.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 293-297 doi: 10.1111/j.2042-3306.1999.tb05237.x
Lacombe V, Hinchcliff KW, Geor RJ, Lauderdale MA.The purpose of this study was to develop a model of muscle glycogen depletion and to study the effect of this model on aerobic and anaerobic capacity of horses. The maximal rate of oxygen consumption (VO2max), maximal accumulated oxygen deficit (MAOD), muscle glycogen concentration and blood lactate concentration of 6 fit Standardbred horses were measured on 3 occasions 7 days apart (Trials 1, 2 and 3). Between Trials 2 and 3, strenuous exercise intended to deplete muscle glycogen was performed by exercising horses on the treadmill on 3 consecutive days. Strenuous exercise resulted in reductio...
Comparison of exercise tests in French trotters under training track, racetrack and treadmill conditions.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 528-532 doi: 10.1111/j.2042-3306.1999.tb05278.x
Couroucé A, Geffroy O, Barrey E, Auvinet B, Rose RJ.Standardised exercise tests were performed at 2 different tracks and on an uninclined treadmill during the same week to determine the influence of exercise surface on different measured variables such as heart rate (HR), blood lactate concentration, packed cell volume, stride frequency, stride length, gait symmetry and regularity and on different derived physiological variables such as the speed at a HR of 200 beats/min (V200), the speed at a blood lactate concentration of 4 mmol/l (V4), the speed at a maximal HR (VHRmax). Five French Trotters, age 3 years, in training for 3 months prior to th...
Blood gas, plasma lactate and bronchoalveolar lavage cytology analyses in racehorses with respiratory disease.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 77-82 doi: 10.1111/j.2042-3306.1999.tb05193.x
Couëtil LL, Denicola DB.The purpose of this study was to evaluate the relationship between bronchoalveolar lavage (BAL) cytology, arterial blood gases and plasma lactate concentration during a standardised treadmill test (STT) in racehorses with small-airway inflammation (SAI), or exercise-induced pulmonary haemorrhage (EIPH). Sixteen Thoroughbred and 20 Standardbred actively racing racehorses, were divided into a control group (n = 10), EIPH group (n = 13) and SAI group (n = 13). Each STT consisted of a 2 min trot at 4 m/s followed by 5 x 1 min, incremental speed steps (6, 8, 10, 11 and 12 m/s) at 10% incline for Th...
Partition of plasma hydrogen ion concentration changes during repeated sprints.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 380-383 doi: 10.1111/j.2042-3306.1999.tb05252.x
Kronfeld DS, Ferrante PL, Taylor LE, Tiegs W.Increases in blood [H+] and lactic acid [La-] attend fatigue. We applied Stewart's physiological model of acid-base status and simple regressions to assess the importance of independent variables and [La-] on [H+] during repeated sprints. Eight well-conditioned Arabians performed 9 sprints. Plasma from jugular vein samples was analysed for pH, PCO2, Na+, K+ and Cl-. Plasma [La-] was calculated from blood [La-], plasma [H+] from pH, SID from Na+, K+, Cl- and La-, Atot from pH, PCO2 and SID. Peaks for SID, PCO2 and [H+] were reached at sprint 1, -2 and -3, respectively. At sprint 3, the 5.7 nmol...
Plasma adrenocorticotropin, cortisol and catecholamines response to various exercises.
Equine veterinary journal. Supplement    February 5, 2000   Issue 30 570-574 doi: 10.1111/j.2042-3306.1999.tb05286.x
Nagata S, Takeda F, Kurosawa M, Mima K, Hiraga A, Kai M, Taya K.The responses of plasma adrenocorticotropin (ACTH), cortisol, noradrenaline and adrenaline in 5 Thoroughbred horses to an incremental exercise and 2 relative workload exercises, at 105 and 80% maximal oxygen consumption (VO2max), on a treadmill were examined. These hormone concentrations increased (P < 0.05) with each exercise and the maximal plasma concentrations of ACTH, cortisol were observed between 5 and 30 min after the end of the exercise, while maximal catecholamine concentrations occurred just at exhaustion time. The plasma ACTH, noradrenaline and adrenaline responses during exerci...
Comparison of some responses to exercise on the track and the treadmill in French trotters: determination of the optimal treadmill incline.
Veterinary journal (London, England : 1997)    January 21, 2000   Volume 159, Issue 1 57-63 doi: 10.1053/tvjl.1999.0381
Couroucé A, Corde R, Valette JP, Cassiat G, Hodgson DR, Rose RJ.The purpose of this study was to determine the optimal treadmill slope for trotters to produce the same heart rate and blood lactate responses as on the track during a standardized exercise test. Nine 2-year-old French trotters performed exercise tests on a training track and on a treadmill set at an incline of 0, 2 or 4%. For all horses, track testing was performed on day 1 and then on the treadmill according to a Latin-square design. The track test utilized three steps each of 3 min at speeds of 470, 530, 590 m/min and the same speeds were used on the treadmill. Derived physiological variabl...
Monitoring training success using a lactate-speed relationship.
Zentralblatt fur Veterinarmedizin. Reihe A    December 22, 1999   Volume 46, Issue 9 565-571 doi: 10.1046/j.1439-0442.1999.00249.x
Mohr E, Krzywanek H, Pinkowski W.Monitoring training by measuring blood lactate content is a well-known procedure in sports physiology. Because of the difficulties in standardizing a test procedure in field studies, this method is fraught with considerable problems when applying it to race horses. The aim of the present study was to develop a test procedure which is able to give evidence about the training state of different race horses after nonidentical test-loads. Under almost identical environmental conditions, the level of blood lactate was determined in five trotters which were kept in training. Immediately after the si...
Locomotor response to exercise in relation to plasma lactate accumulation and heart rate in Andalusian and Anglo-Arabian horses.
Veterinary research communications    October 30, 1999   Volume 23, Issue 6 369-384 doi: 10.1023/a:1006337708920
Muñoz A, Santisteban R, Rubio MD, Riber C, Agüera EI, Castejón FM.To establish the effect of the locomotor pattern on heart rate (HR) and plasma lactate (LA), 28 horses, 18 Andalusian (AN) and 10 Anglo-Arabian (AA), aged 3-4 years, were studied. After a warm-up period, the horses performed a four-step test at 5, 6, 7 and 8 m/s, covering 1000 m at each velocity. HR was monitored, LA was analysed at rest and after each workload, and images were filmed. The locomotor parameters determined were stride duration (SD), frequency (SF) and length (SL), step and bipedal support durations, stance (restraint and propulsion) and swing phase durations, and stride vertical...
Effects of muscle glycogen depletion on some metabolic and physiological responses to submaximal treadmill exercise.
Canadian journal of veterinary research = Revue canadienne de recherche veterinaire    October 26, 1999   Volume 63, Issue 4 241-247 
Davie AJ, Evans DL, Hodgson DR, Rose RJ.The aim of this study was to investigate the effects of reduced muscle glycogen concentration on some physiological and metabolic responses during moderate intensity treadmill exercise in horses. Six Thoroughbred geldings were randomly allocated to 2 treatments (protocols A and B) or control in a 3 x 3 replicated Latin square design. In protocol A, horses performed low intensity exercise while horses in protocol B performed short bursts of high intensity exercise. Protocol A was designed to induce glycogen depletion mainly of slow twitch muscle fibers while protocol B aimed to deplete mainly f...
Effects of glucose infusion on the endocrine, metabolic and cardiorespiratory responses to halothane anaesthesia of ponies.
The Veterinary record    August 26, 1999   Volume 145, Issue 4 100-103 doi: 10.1136/vr.145.4.100
Luna SP, Taylor PM, Brearley JC.Glucose was infused intravenously into six ponies during halothane anaesthesia, to evaluate its effect on their endocrine response to anaesthesia. The ponies were premedicated with acepromazine, and anaesthesia was induced with thiopentone and maintained with halothane in oxygen for two hours. Glucose was infused to maintain the plasma glucose concentration above 20 mmol/litre. Anaesthesia was associated with hypothermia, a decrease in haematocrit, hypotension, hyperoxaemia, respiratory acidosis and an increase in the plasma concentrations of lactate and arginine vasopressin. The concentration...
A comparison of the ultrastructure and metabolic response of the skeletal muscle of horses performing intense treadmill exercise at 20 and 35 degrees C.
Zentralblatt fur Veterinarmedizin. Reihe A    July 10, 1999   Volume 46, Issue 4 209-218 doi: 10.1046/j.1439-0442.1999.00204.x
Gottlieb-Vedi M, Essén-Gustavsson B, Thornell LE, Lindholm A.The aim of this study was to determine whether the metabolic response and ultrastructure of muscle differed when horses performed intense exercise at different ambient temperatures. Four Standardbred geldings performed treadmill exercise, including an intensive trot of 2600 m on two different occasions, either at a high ambient temperature of 35 degrees C or at a temperature of 20 degrees C. The horses had a warm-up period of 23.5 min of submaximal exercise, followed by 2 h of box rest before the intensive exercise. Muscle biopsy data of adenine nucleotides, creatine phosphate, lactate and gly...
Effect of exercise on the immune response of young and old horses.
American journal of veterinary research    May 18, 1999   Volume 60, Issue 5 643-647 
Horohov DW, Dimock A, Guirnalda P, Folsom RW, McKeever KH, Malinowski K.To compare exercise-induced immune modulation in young and older horses. Methods: 6 young and 6 aged horses that were vaccinated against equine influenza virus. Methods: Venous blood samples were collected for immunologic assessment before and immediately after exercise at targeted heart rates and after exercise for determination of plasma lactate and cortisol concentrations. Mononuclear cells were assayed for lymphoproliferative responses and incubated with interleukin-2 (IL-2) to induce lymphokine-activated killer (LAK) cells. Antibodies to equine influenza virus were measured. Results: Olde...
The influence of betaine on untrained and trained horses exercising to fatigue.
Journal of animal science    May 6, 1999   Volume 77, Issue 3 677-684 doi: 10.2527/1999.773677x
Warren LK, Lawrence LM, Thompson KN.Because exercise fatigue has been associated with the accumulation of lactic acid, factors that influence lactate metabolism during exercise can potentially enhance performance. The objective of this study was to examine the effects of supplemental betaine on eight mature Thoroughbred horses before and after 8 wk of conditioning. The effects of betaine were tested in two cross-over design experiments, allowing each horse to receive both the control and betaine treatments at each fitness level. Ingestion of 80 mg of betaine/kg of BW for 14 d before exercise testing did not alter plasma lactate,...
Muscle characteristics and plasma lactate and ammonia response after racing in Standardbred trotters: relation to performance.
Equine veterinary journal    April 23, 1999   Volume 31, Issue 2 170-173 doi: 10.1111/j.2042-3306.1999.tb03811.x
Ronéus N, Essén-Gustavsson B, Lindholm A, Persson S.Blood samples from the jugular vein and muscle biopsies (gluteus medius) in 25 Standardbred trotters were obtained 5-10 min after racing. The biopsies were analysed for fibre type composition and enzymatic profile and blood samples for plasma lactate and ammonia concentrations. Muscle characteristics, plasma lactate and ammonia concentrations after racing were compared with each horse's individual performance index (IPI). The IPI is calculated annually from the individual horse's racing performance (% placing 1, 2 or 3, total annual earnings, average earning per start, and best racing record),...
Metabolic effects of nitric oxide synthase inhibition during exercise in the horse.
Research in veterinary science    April 20, 1999   Volume 66, Issue 2 135-138 doi: 10.1053/rvsc.1998.0258
Mills PC, Marlin DJ, Scott CM, Smith NC.The effect of nitric oxide synthase (NOS) inhibition during exercise on lactate production was investigated in five Thoroughbred horses. A standard exercise test (SET), consisting of three canters (approximately 55 per cent VO2max), with walking and trotting between each canter, was performed twice (control and test, in random order) by each horse. Nphi-nitro-L-arginine methyl ester (L-NAME; 20 mg kg-1), a competitive inhibitor of NOS, induced a significant increase (P < 0.05) in plasma lactate [5.7 (2.9) vs 11.8 (3.8) mmol L-1], which continued to increase despite administration of L-argin...
Field exercise testing for assessing fitness in French standardbred trotters.
Veterinary journal (London, England : 1997)    April 16, 1999   Volume 157, Issue 2 112-122 doi: 10.1053/tvjl.1998.0302
Couroucé A.This review considers standardized exercise testing which is, routinely used for French Trotters in the field. Track testing provides a more limited range of measurements than treadmill testing, but has the advantage of being performed in the horse's natural environment. Various measurements such as heart rate during exercise and blood lactate concentration after exercise may be measured on the track and lead to the calculation of physiological variables such as V200 (velocity corresponding to a 200 bpm heart rate) and V4 (velocity corresponding to a 4 mmol/L blood lactate concentration). V4 i...
Evaluation of peritoneal fluid pH, glucose concentration, and lactate dehydrogenase activity for detection of septic peritonitis in horses.
Journal of the American Veterinary Medical Association    April 14, 1999   Volume 214, Issue 7 1032-1036 
Van Hoogmoed L, Rodger LD, Spier SJ, Gardner IA, Yarbrough TB, Snyder JR.To determine whether peritoneal fluid pH, glucose concentration, and lactate dehydrogenase activity can be used to differentiate horses with septic peritonitis from those with nonseptic peritonitis. Methods: Prospective study. Methods: 46 horses, including 10 healthy horses, 15 horses with septic peritonitis, and 21 horses with nonseptic peritonitis. Methods: Peritoneal fluid and blood samples were analyzed for pH, glucose concentration, and lactate dehydrogenase activity. Complete blood cell counts were performed, and peritoneal fluid samples were submitted for bacterial culture. Results: Hor...
V(O2) recovery kinetics in the horse following moderate, heavy, and severe exercise.
Journal of applied physiology (Bethesda, Md. : 1985)    April 8, 1999   Volume 86, Issue 4 1170-1177 doi: 10.1152/jappl.1999.86.4.1170
Langsetmo I, Poole DC.At the onset of exercise, horses exhibit O2 uptake (VO2) kinetics that are qualitatively similar to those of humans. In humans, there is a marked dissymmetry between on- and off-kinetics for VO2. This investigation sought to formally characterize the off-transient (recovery) VO2 kinetics in the horse within the moderate (M), heavy (H), and severe (S) exercise domains. Six horses were run on a high-speed treadmill at M, H, and S exercise intensities (i.e., that speed which yielded approximately 50, 85, 100% peak VO2, respectively, on the maximal incremental test). The time courses for the recov...
Effects of hypoxia on endocrine and metabolic responses to anaesthesia in ponies.
Research in veterinary science    March 24, 1999   Volume 66, Issue 1 39-44 doi: 10.1053/rvsc.1998.0236
Taylor PM.Some metabolic and endocrine effects of hypoxaemia were studied during halothane anaesthesia in six ponies. Each was anaesthetised twice; on one occasion a 20-minute period of hypoxaemia (arterial oxygen tension between 4.4 and 5.8 [mean 5.3] kPa) was imposed during 120 minutes of anaesthesia. On the second occasion arterial oxygen tension was maintained above 17 kPa throughout. Routine cardiovascular monitoring was performed and blood samples were taken to measure haematocrit, cortisol, insulin, glucose and lactate. Anaesthesia was associated with hypotension in both groups (mean ABP 7.0 kPa...
Locomotor, cardiocirculatory and metabolic adaptations to training in Andalusian and Anglo-Arabian horses.
Research in veterinary science    March 24, 1999   Volume 66, Issue 1 25-31 doi: 10.1053/rvsc.1998.0235
Muñoz A, Santisteban R, Rubio MD, Agüera EI, Escribano BM, Castejón FM.The effects of two training programmes in 20 Andalusian and 12 Anglo-Arabian horses were evaluated by an increasing intensity work test at velocities of 4, 5, 6, 7 and 8 m sec(-1). Heart rate was monitored and blood samples were drawn at rest and after each velocity to analyse packed cell volume, haemoglobin concentration, plasma lactate and potassium levels. Furthermore, the programmes were video-taped and stride length, duration and frequency, stance (restraint and propulsion), swing phase durations and stride vertical component were measured. The training protocol of the Andalusian horses p...
Cardiovascular and metabolic adaptations in horses competing in cross-country events.
The Journal of veterinary medical science    February 23, 1999   Volume 61, Issue 1 13-20 doi: 10.1292/jvms.61.13
Muñoz A, Riber C, Santisteban R, Rubio MD, Agüera EI, Castejón FM.The cardiovascular and metabolic response to two cross-country events (CC*: preliminary level and CC*** advanced level) were analysed in 8 male eventing horses (4 Anglo-Hunter and 4 Anglo-Arabian). This study focused on the establishment of the main metabolic pathways involved in the muscle energy resynthesis during the competitions. Heart rate (HR) was recorded throughout the CC events. Jugular venous blood samples were withdrawn before the warm-up period, immediately after the competitions and at 5 and 10 min in the recuperation period. The following haematological parameters were studied: r...
Skeletal muscle metabolic response to exercise in horses with ‘tying-up’ due to polysaccharide storage myopathy.
Equine veterinary journal    February 10, 1999   Volume 31, Issue 1 43-47 doi: 10.1111/j.2042-3306.1999.tb03789.x
Valberg SJ, Macleay JM, Billstrom JA, Hower-Moritz MA, Mickelson JR.Polysaccharide storage myopathy (PSSM) is a distinct cause of exertional rhabdomyolysis in Quarter Horses that results in glycogen and abnormal polysaccharide accumulation. The purpose of this study was to determine if excessive glycogen storage in PSSM is due to a glycolytic defect that impairs utilisation of this substrate during exercise. Muscle biopsies, blood lactates and serum CK were obtained 1) at rest from 5 PSSM Quarter Horses, 4 normal Quarter Horses (QH controls) and 6 Thoroughbreds with recurrent exertional rhabdomyolysis (TB RER) and 2) after a maximal treadmill exercise test in ...
Endocrine and metabolic responses to plasma volume expansion during halothane anesthesia in ponies.
Journal of veterinary pharmacology and therapeutics    January 14, 1999   Volume 21, Issue 6 485-490 doi: 10.1046/j.1365-2885.1998.00169.x
Taylor PM.The study was designed to contribute to identification of the stimulus to adrenocortical activity during halothane anaesthesia in equidae. Two groups of six ponies were premedicated with acepromazine before induction of anaesthesia with thiopentone and maintenance for 120 min with halothane in oxygen. In group H Haemaccel modified gelatine plasma replacer was infused (48+/-13 mL/kg) to maintain mean arterial blood pressure (MABP) close to preanaesthetic values. In group DH, blood pressure was maintained close to preanaesthetic levels with a lower dose of Haemaccel (10 mL/kg) combined with an i...
Muscle anaerobic response to a maximal treadmill exercise test in Standardbred trotters.
Equine veterinary journal    December 9, 1998   Volume 30, Issue 6 504-510 doi: 10.1111/j.2042-3306.1998.tb04526.x
Schuback K, Essén-Gustavsson B.The purpose of this study was to develop a standardised maximal treadmill exercise test performed until fatigue in order to find reproducible markers for anaerobic metabolism, specifically adenine nucleotide degradation. Six Standardbred trotters performed an incremental maximal treadmill exercise test in 1 min steps (starting with 7 m/s) until they could no longer keep pace with the treadmill. The test was performed twice with at least one week between the tests. Heart rate was recorded and venous blood samples were obtained during the test and in the recovery period for determination of plas...
Effects of hypercapnia on endocrine and metabolic responses to anaesthesia in ponies.
Research in veterinary science    October 13, 1998   Volume 65, Issue 1 41-46 doi: 10.1016/s0034-5288(98)90025-x
Taylor PM.Some metabolic and endocrine effects of hypercapnia were studied in six ponies during halothane anaesthesia with neuromuscular blockade and controlled ventilation. Each was anaesthetised twice, once with a 40-minute-period of hypercapnia (10 kPa) and once when normocapnia (5.3 kPa) was maintained throughout two hour's anaesthesia. Routine cardiovascular monitoring was performed and blood samples were taken for assay of cortisol, insulin, glucose, lactate, muscle and liver enzymes and total protein. Anaesthesia induced hypotension and lacticacidaemia which were slightly ameliorated during hyper...
Adrenocortical and metabolic responses to dobutamine infusion during halothane anaesthesia in ponies.
Journal of veterinary pharmacology and therapeutics    September 10, 1998   Volume 21, Issue 4 282-287 doi: 10.1046/j.1365-2885.1998.00130.x
Taylor PM.The study investigated whether hypotension in halothane-anaesthetised ponies is the stimulus inducing an endocrine stress response by assessing the effect of maintenance of normotension with a dobutamine infusion. Groups of six ponies were studied. After premedication with acepromazine (0.04 mg/kg) anaesthesia was induced with thiopentone (10 mg/kg) and maintained for 120 min with halothane (group AN). Dobutamine was infused to effect (1.1-4.4 microg/kg/min) to maintain arterial pressure at pre anaesthetic levels. The conscious group (CON) were prepared as for AN and then received only dobutam...
Selected blood parameters during recovery from strenuous running exertion in trotters.
Zentralblatt fur Veterinarmedizin. Reihe A    August 28, 1998   Volume 45, Issue 5 279-286 doi: 10.1111/j.1439-0442.1998.tb00828.x
Pinkowski W, Mohr E, Krzywanek H.During training, in 10 trotters, blood samples from the vena jugularis were taken before and after a heat with 80% of maximum capability as well as in the recovery period. Lactic acid concentration and pH-value, haematocrit and haemoglobin content, as well as protein concentration and osmolality were measured. With the exception of protein concentration, the time course of the values during the recovery could be described by simple mathematical models (biexponential or exponential equations). Only in the case of blood lactate concentration, the basal value was not yet achieved 120 min after th...
Characteristics of respiratory function during swimming exercise in thoroughbreds.
The Journal of veterinary medical science    July 23, 1998   Volume 60, Issue 6 687-689 doi: 10.1292/jvms.60.687
Hobo S, Yoshida K, Yoshihara T.Equine respiratory patterns during swimming were examined in five normal horses. The experiment included a preliminary warming-up stage and 6 circuits of swimming around an annular pool of a 50-meter-circumference. The horses were examined for respiratory rates, intratracheal pressures, inspiratory time (TI), expiratory time (TE), respiratory cycle (T; TI + TE), heart rates, blood lactate concentrations, hematocrit and blood gases. The respiratory rates were maintained around 25/min. Blood gas values changed significantly during swimming. The intratracheal pressures during expiration and inspi...
Comparison of anion gap and strong ion gap as predictors of unmeasured strong ion concentration in plasma and serum from horses.
American journal of veterinary research    July 11, 1998   Volume 59, Issue 7 881-887 
Constable PD, Hinchcliff KW, Muir WW.To compare the accuracy of anion gap (AG) and strong ion gap (SIG) for predicting unmeasured strong ion concentration in plasma and serum from horses. Methods: 6 well-trained Standardbred horses undergoing high-intensity exercise (experimental study) and 78 horses and ponies that underwent i.v. administration of lactic acid or endotoxin, and endurance, submaximal, or high-intensity exercise. Methods: Anion gap was calculated as AG = (Na+ + K+) - (Cl- + HCO3-), and SIG was calculated, using the simplified strong ion model, whereby SIG (mEq/L) = 2.24 x total protein (g/dl)/(1 + 10(6.65-pH)) - AG...
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