Case for standard-base excess as the measure of nonrespiratory acid-base imbalance

1991 ◽  
Vol 7 (3) ◽  
pp. 276-277 ◽  
Author(s):  
John W. Severinghaus
Keyword(s):  
Base Excess ◽  
Acid Base ◽  
Standard Base Excess ◽  
Standard Base

scholarly journals Base-excess chloride; the best approach to evaluating the effect of chloride on the acid- base status: a retrospective study

2020 ◽  
Author(s):  
Bulent Gucyetmez ◽  
Filiz Tuzuner ◽  
Hakan Korkut Atalan ◽  
Ugur Sezerman ◽  
Kaan Gucyetmez ◽  
...  
Keyword(s):  
Linear Regression ◽  
Regression Model ◽  
Linear Regression Model ◽  
Base Excess ◽  
Strong Ion Difference ◽  
Acid Base ◽  
Standard Base Excess ◽  
Serum Chloride ◽  
Acid Base Status ◽  
Standard Base

Abstract Background: To determine the effect of chloride on the acid-base status, four approaches are currently used: 1) accepted ranges of serum chloride values; 2) chloride corrections, such as chloride deficiency/excess and chloride modification; 3) the Cl/Na ratio; and 4) the sodium- chloride difference, such as base-excess chloride. However, these approaches are governed by different concepts, and they can evaluate the effects of chloride on the acid-base status differently. Our aim is to investigate which approach to the evaluation of the effect of chloride is the best.Methods: In this retrospective cohort study, 2529 critically ill patients who were admitted to the tertiary care unit were evaluated between 2011 and 2018. Patient characteristics and blood gas parameters at the ICU admission and outcomes were recorded. The effects of chloride on the acid-base status according to each evaluative approach were validated by the standard base excess and apparent strong ion difference. To compare approaches, kappa and Bland-Altman tests and a linear regression model were used. Results: In the linear regression model for all patients, only base-excess chloride in all the chloride evaluation approaches was significantly related to the standard base excess. In the subgroup, the correlation and limits of agreement between base-excess chloride and the standard base excess were the strongest (r2=0.92 p<0.001 bias: 0.5mmol/L). Conclusions: For the evaluation of the effect of chloride on the acid-base status, base-excess chloride is a better approach than accepted ranges of serum chloride values, chloride corrections and the Cl/Na ratio.

scholarly journals Acid-Base Effects of a Bicarbonate-Balanced Priming Fluid during Cardiopulmonary Bypass: Comparison with Plasma-Lyte 148. A Randomised Single-Blinded Study

2008 ◽  
Vol 36 (6) ◽  
pp. 822-829 ◽  
Author(s):  
T. J. Morgan ◽  
G Power ◽  
B. Venkatesh ◽  
M. A. Jones
Keyword(s):  
Metabolic Acidosis ◽  
Cardiopulmonary Bypass ◽  
Base Excess ◽  
Strong Ion Difference ◽  
Acid Base ◽  
Elective Cardiac Surgery ◽  
Standard Base Excess ◽  
Acid Base Status ◽  
Standard Base ◽  
Normal Acid

Fluid-induced metabolic acidosis can be harmful and can complicate cardiopulmonary bypass. In an attempt to prevent this disturbance, we designed a bicarbonate-based crystalloid circuit prime balanced on physico-chemical principles with a strong ion difference of 24 mEq/l and compared its acid-base effects with those of Plasma-Lyte 148, a multiple electrolyte replacement solution containing acetate plus gluconate totalling 50 mEq/l. Twenty patients with normal acid-base status undergoing elective cardiac surgery were randomised 1:1 to a 2 litre prime of either bicarbonate-balanced fluid or Plasma-Lyte 148. With the trial fluid, metabolic acid-base status was normal following bypass initiation (standard base excess 0.1 (1.3) mEq/l, mean, SD), whereas Plasma-Lyte 148 produced a slight metabolic acidosis (standard base excess -2.2 (2.1) mEq/l). Estimated group difference after baseline adjustment was 3.6 mEq/l (95% confidence interval 2.1 to 5.1 mEq/l, P=0.0001). By late bypass, mean standard base excess in both groups was normal (0.8 (2.2) mEq/l vs. -0.8 (1.3) mEq/l, P=0.5). Strong ion gap values were unaltered with the trial fluid, but with Plasma-Lyte 148 increased significantly on bypass initiation (15.2 (2.5) mEq/l vs. 2.5 (1.5) mEq/l, P <0.0001), remaining elevated in late bypass (8.4 (3.4) mEq/l vs. 5.8 (2.4) mEq/l, P <0.05). We conclude that a bicarbonate-based crystalloid with a strong ion difference of 24 mEq/l is balanced for cardiopulmonary bypass in patients with normal acid-base status, whereas Plasma-Lyte 148 triggers a surge of unmeasured anions, persisting throughout bypass. These are likely to be gluconate and/or acetate. Whether surges of exogenous anions during bypass can be harmful requires further study.

Human PaCO2 and standard base excess compensation for acid-base imbalance

1998 ◽  
Vol 26 (7) ◽  
pp. 1173-1179 ◽  
Author(s):  
Robert Schlichtig ◽  
Alan W. Grogono ◽  
John W. Severinghaus
Keyword(s):  
Base Excess ◽  
Acid Base ◽  
Standard Base Excess ◽  
Standard Base

scholarly journals Partitioning evolutive standard base excess determinants in septic shock patients

2007 ◽  
Vol 19 (4) ◽  
pp. 437-443 ◽  
Author(s):  
Marcelo Park ◽  
Danilo Teixeira Noritomi ◽  
Alexandre Toledo-Maciel ◽  
Luciano Cesar Pontes de Azevedo ◽  
Vladimir Ribeiro Pizzo ◽  
...  
Keyword(s):  
Septic Shock ◽  
Base Excess ◽  
Standard Base Excess ◽  
Standard Base

Effect of Paco2 variation on standard base excess value in critically ill patients

2009 ◽  
Vol 24 (4) ◽  
pp. 484-491 ◽  
Author(s):  
Marcelo Park ◽  
Alexandre Toledo Maciel ◽  
Danilo Teixeira Noritomi ◽  
Luciano Cesar Pontes de Azevedo ◽  
Leandro Utino Taniguchi ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Base Excess ◽  
Standard Base Excess ◽  
Excess Value ◽  
Standard Base

scholarly journals Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy: still outcome markers?

Clinics ◽  
2006 ◽  
Vol 61 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Marcelo Park ◽  
Luciano Cesar Pontes Azevedo ◽  
Alexandre Toledo Maciel ◽  
Vladimir Ribeiro Pizzo ◽  
Danilo Teixeira Noritomi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Base Excess ◽  
Serum Lactate ◽  
Serum Lactate Level ◽  
Goal Directed Therapy ◽  
Early Goal Directed Therapy ◽  
Standard Base Excess ◽  
Standard Base ◽  
Sepsis And Septic Shock
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