Recent observations made in different laboratories have emphasized the fact that the total electrolyte content of the blood plasma, and presumably of the body fluids in general, tends to be maintained at a relatively constant level in spite of wide variations in the concentrations of individual ions, and in spite of large fluctuations of plasma water content.
In experimental pyloric obstruction, Gamble and Ross1 called particular attention to the fact that the total base of the plasma is altered but slightly when enormous reduction of chloride and increase of bicarbonate occur. A similar deduction was made by Hartmann and Smyth2 in their study of pyloric stenosis, intestinal obstruction, intestinal fistula and persistent vomiting due to parenteral infections in infants and children. In these conditions, it was apparent that the maintenance of total electrolyte (or fixed base, as expressed by Gamble) took precedence over the maintenance of the normal
DARROW DC, HARTMANN AF. A COMPARISON OF THE CALCULATED AND DETERMINED OSMOLAR CONCENTRATION OF NORMAL SERUMTHE BASE-BINDING POWER OF PROTEINS AND THE DETERMINATION OF TOTAL BASE. Am J Dis Child. 1929;37(1):51-60. doi:10.1001/archpedi.1929.01930010058003