As part of arterial blood gas analysis, base excess is often reported as a measure of non-respiratory acid-base disturbance. Most blood gas analysers offer the option of calculating either the base excess of the blood sample or the base excess of the extracellular fluid (ECF). We report a case that illustrates that selecting the physiologically appropriate parameter avoids the potential for misinterpretation of acid-base data. We recommend that the base excess of the ECF is the appropriate metabolic blood gas parameter for clinical use.
References
1.
BrackettNCCohenJJSchwartzWB. Carbon dioxide titration curve of normal man: effect of increasing degrees of acute hypercapnia on acid-base equilibrium. New Engl J Med1965; 272: 6–12.
2.
BunkerJP. The great trans-atlantic acid-base debate. J Anesthesiol1965; 26: 591–4.
3.
MellemgaardKAstrupP. The quantitative determination of surplus amounts of acid or base in the human body. Scand J Clin Lab Invest1960; 12: 187–99.
4.
SeveringhausJW. Acid-base balance nomogram: a Boston-Copenhagen détente. Anesthesiol1976; 5: 539–41.
5.
KofstadJ. Base excess: a historical review - has the calculation of base excess been more standardised in the last 20 years?Clin Chim Acta2001307: 193–5.
6.
Siggaard-AndersenOFogh-AndersenN. Base excess or buffer base (strong ion difference) as a measure of a non-respiratory acid-base disturbance. Acta Anaesth Scand1995; 39 (Suppl 107): 123–8.
