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The CO2 (bicarbonate) value on a basic metabolic panel is a surrogate for blood bicarbonate, reflecting the body's primary chemical buffer against acidosis. Low CO2 (metabolic acidosis) is associated with advanced kidney disease, diabetic ketoacidosis, lactic acidosis, or diarrhoea; high CO2 (metabolic alkalosis) is typically caused by prolonged vomiting, diuretic use, or mineralocorticoid excess. In people with chronic kidney disease, a low bicarbonate independently accelerates kidney function loss and is now actively treated.
Also known as: Bicarb, Bicarbonate, Bicarbonate (CO2), Bicarbonato, Carbon Dioxide, Carbon dioxide, Total, Carbonic anhydride, cCO2
High CO2 indicates metabolic alkalosis from chronic vomiting or diuretic overuse. Low CO2 signals metabolic acidosis from diabetic ketoacidosis, lactic acidosis, or kidney failure.
Standard range is 22-29 mmol/L. Functional practitioners target 24-27 mmol/L. This marker measures bicarbonate, not dissolved gas.