Type of test Blood
Normal findings
Adult/elderly: 98-106 mEq/L or 98-106 mmol/L (SI units)
Child: 90-110 mEq/L
Newborn: 96-106 mEq/L
Premature infant: 95-110 mEq/L
Possible critical values
< 80 or > 115 mEq/L
Test explanation and related physiology
This test is performed as a part of multiphasic testing in what is usually called electrolytes, Astra-7, chemprofile, metabolic panel, kidney profile, comprehensive profile, SMA 12, or SMA 6. By itself, not much information is obtained. However, with interpretation of the other electrolytes, chloride can give an indication of acid–base balance and hydrational status.
Hypochloremia and hyperchloremia rarely occur alone and are usually part of parallel shifts in sodium or bicarbonate levels. Signs and symptoms of hypochloremia include hyperexcitability of the nervous system and muscles, shallow breathing, hypotension, and tetany. Signs and symptoms of hyperchloremia include lethargy, weakness, and deep breathing.
Interfering factors
• Excessive infusions of saline can result in increased chloride levels.
* Drugs that may cause increased serum chloride levels include acetazolamide, ammonium chloride, androgens, chlorothiazide, cortisone preparations, estrogens, guanethidine, hydro chlorothiazide, methyldopa, and nonsteroidal antiinflammatory drugs (NSAIDs).
* Drugs that may cause decreased levels include aldosterone, bicarbonates, corticosteroids, cortisone, hydrocortisone, loop diuretics, thiazide diuretics, and triamterene.
Procedure and patient care
• See inside front cover for Routine Blood Testing.
• Fasting: no
• Blood tube commonly used: red or green
Abnormal findings
Increased levels (hyperchloremia)
- Dehydration
- Renal tubular acidosis
- Excessive infusion of normal saline
- Cushing syndrome
- Eclampsia
- Multiple myeloma
- Kidney dysfunction
- Metabolic acidosis
- Hyperventilation
- Anemia
- Respiratory alkalosis
- Hyperparathyroidism
Decreased levels (hypochloremia)
- Overhydration
- Congestive heart failure
- Syndrome of inappropriate antidiuretic hormone
- Vomiting
- Chronic gastric suction
- Chronic respiratory acidosis
- Salt-losing nephritis
- Addison disease
- Burns
- Metabolic alkalosis
- Diuretic therapy
- Hypokalemia
-Aldosteronism
- Respiratory acidosis
