Base excess: A review

Journal of Trauma and Acute Care Surgery

Volumn 73, Issue 1, 2012, Pages 27-32

  Juern, Jeremy ^a   Khatri, Vikram ^b   Weigelt, John ^a  

^a Division of Trauma   (United States)

^b MEDICAL COLLEGE OF WISCONSIN   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ALCOHOL; BICARBONATE; CARBON DIOXIDE; LACTIC ACID; SODIUM;

ACIDOSIS; ACUTE KIDNEY FAILURE; ALKALOSIS; ANAEROBIC METABOLISM; ANION GAP; BURN; FLUID RESUSCITATION; HEMODIALYSIS; HUMAN; HYPERCHLOREMIA; HYPOVOLEMIC SHOCK; INJURY; INTENSIVE CARE UNIT; METABOLIC ACIDOSIS; METABOLIC ALKALOSIS; MORTALITY; NONHUMAN; OXIDATIVE PHOSPHORYLATION; OXYGEN CONSUMPTION; OXYGEN SATURATION; PH; PRIORITY JOURNAL; RESUSCITATION; REVIEW;

ALKALOSIS; BURNS; CARBON DIOXIDE; HUMANS; HYDROGEN-ION CONCENTRATION; INTENSIVE CARE UNITS; KIDNEY DISEASES; RESUSCITATION; WOUNDS AND INJURIES;

EID: 84864237245     PISSN: 21630755     EISSN: 21630763     Source Type: Journal    
DOI: 10.1097/TA.0b013e318256999d     Document Type: Review

References (46)

1. Astrup P, Severinghaus JW. The History of Blood Gases, Acids, and Bases. Copenhagen, Denmark: Munksgaard; 1986.
2. Siggaard-Andersen O. An acid-base chart for arterial blood with normal and pathophysiological reference areas. Scan J Clin Lab Invest. 1971;27: 239Y245.
3. Astrup P, Andersen OS, Jorgensen K, et al. The acid-base metabolism: a new approach. Lancet. 1960;1:1035Y1039.
4. Schlichtig R, Grogono AW, Severinghaus JW. Human PaCO2 and standard base excess compensation for acid-base imbalance. Crit Care Med. 1998; 26:1173Y1179.
5. Siggaard Andersen O. Blood acid-base alignment nomogram: scales for pH, PCO2, base excess of whole blood of different hemoglobin concentrations, plasma bicarbonate, and plasma total-CO2. Scan J Clin Lab Invest. 1963; 15:211Y217.
6. Severinghaus JW. Acid-base balance nomogramVa Boston-Copenhagen detente. Anesthesiology. 1976;45:539Y541.
7. Kofstad J. Base excess: a historical reviewVhas the calculation of base excess been more standardised the last 20 years? Clin Chim Acta. 2001; 307:193Y195.
8. Davis JW, Kaups KL, Parks SN. Base deficit is superior to pH in evaluating clearance of acidosis after traumatic shock. J Trauma. 1998;44:114Y118.
9. Siegel JH, Rivkind AI, Dalal S, Goodarzi S. Early physiologic predictors of injury severity and death in blunt multiple trauma. Arch Surg. 1990;125: 498Y508.
10. Rutherford EJ, Morris JA, Reed GW, Hall KS. Base deficit stratifies mortality and determines therapy. J Trauma. 1992;33:417Y423.
11. Davis JW, Mackersie RC, Holbrook TL, et al. Base deficit as an indicator of significant abdominal injury. Ann Emerg Med. 1991;20:842Y844.
12. Mackersie RC, Tiwary AD, Shackford SR, et al. Intra-abdominal injury following blunt trauma. Arch Surg. 1989;124:809Y813.
13. Davis JW, Parks SN, Kaups KL, et al. Admission base deficit predicts transfusion requirements and risk of complications. J Trauma. 1996;41: 769Y774.
14. Davis JW, Shackford SR, Mackersie RC, et al. Base deficit as a guide to volume resuscitation. J Trauma. 1988;28:1464Y1467.
15. Callaway DW, Shapiro NI, Donnino MW, et al. Serum lactate and base deficit as predictor of mortality in normotensive elderly blunt trauma patients. J Trauma. 2009;66:1040Y1044.
16. Davis JW, Kaups KL. Base deficit in the elderly: a marker of severe injury and death. J Trauma. 1998;45:873Y877.
17. KincaidEH, ChangMC, Letton RW, et al.Admission base deficit in pediatric trauma: a study using the national trauma data bank. J Trauma. 2001;51: 332Y335.
18. Randolph L, Takacs M, Davis KM. Resuscitation in the pediatric trauma population: admission base deficit remains an important prognostic indicator. J Trauma. 2002;53:838Y842.
19. Kaups KL, Davis JW, Dominic WJ. Base deficit as an indicator or resuscitation needs in patients with burn injuries. J Burn Care Rehabil. 1998;19:346Y348.
20. Cancio LC, Galvez E Jr, Turner CE, et al. Base deficit and alveolar-arterial gradient during resuscitation contribute independently but modestly to the prediction of mortality after burn injury. J Burn Care Res. 2006;27: 289Y297.
21. Choi J, Cooper A, Gomez M, et al. The relevance of base deficits after burn injuries. J Burn Care Rehabil. 2000;21:499Y505.
22. Cartotto R, Choi J, Gomez M, et al. A prospective study on the implications of a base deficit during fluid resuscitation. J Burn Care Rehabil. 2003; 24:75Y84.
23. Andel D, Kamolz LP, Roka J, et al. Base deficit and lactate: early predictors of morbidity and mortality in patients with burns. Burns. 2007;33: 973Y978.
24. Light TD, Jeng JC, Jain AK, et al. Real-time metabolic monitors, ischemiareperfusion, titration endpoints, and ultraprecise burn resuscitation. J Burn Care Rehabil. 25:33Y44.
25. Mikulaschek A, Henry SM, Donovan R, et al. Serum lactate is not predicted by anion gap or base excess after trauma resuscitation. J Trauma. 1996; 40:218Y222.
26. Chawla LS, Jagasia D, Abell LM, et al. Anion gap, anion gap corrected for albumin, and base deficit fail to accurately diagnose clinically significant hyperlactatemia in critically ill patients. J Intensive Care Med. 2008;23: 122Y127.
27. Chawla LS,Nader A,Nelson T, et al.Utilization of base deficit and reliability of base deficit as a surrogate for serum lactate in the peri-operative setting. BMC Anesthesiol. 2010;10:16.
28. Chawla LS, Shih S, Davison D, et al. Anion gap, anion gap corrected for albumin, base deficit and unmeasured anions in critically ill patients: implications on the assessment of metabolic acidosis and the diagnosis of hyperlactatemia. BMC Emerg Med. 2008;8:18.
29. Martin MJ, FitzSullivan E, Salim A, et al. Discordance between lactate and base deficit in the surgical intensive care unit: which one do you trust? Am J Surg. 2006;191:625Y630.
30. Moomey CB, Melton SM, Croce MA, et al. Prognostic value of blood lactate, base deficit, and oxygen-derived variables in an LD50 model of penetrating trauma. Crit Care Med. 1999;27:154Y161.
31. Grogono AW. Acid-base balance. Int Anesthesiol Clin. 1986:24:11Y20.
32. Bannon MP, O'Neill CM. Central venous oxygen saturation, arterial base deficit, and lactate concentration in trauma patients. Am Surg. 1995;61: 738Y746.
33. Cohn SM, Nathens AB, Moore FA, et al. Tissue oxygen saturation predicts the development of organ dysfunction during traumatic shock resuscitation. J Trauma. 2006;62:44Y45.
34. Boyd O, Mackay CJ. Comparison of clinical information gained from routine blood-gas analysis and from gastric tonometry for intramural pH. Lancet. 1993;341:142Y146.
35. Brill SA, Stewart TR, Brundage SI, et al. Base deficit does not predict mortality when secondary to hyperchloremic acidosis. Shock. 2002;17: 459Y462.
36. Sinert R, Zehtabchi S, Bloem C, et al. Effect of normal saline infusion on the diagnostic utility of base deficit in identifying major injury in trauma patients. Acad Emerg Med. 2006;13:1269Y1274.
37. Story DA. Strong ions, weak acids and base excess: a simplified Fencl-Stewart approach to clinical acid-base disorders. Br J Anaesth. 2004;92:54Y60.
38. Nagaoka D, Nassar Junior AP, Maciel AT, et al. The use of sodium-chloride difference and chloride-sodiumratio as strong ion difference surrogates in the evaluation of metabolic acidosis in critically ill patients. J Crit Care. 2010; 25:525Y531.
39. Morgan TJ. Standard base excess. Australas Anaesth. 2003;95Y104.
40. Zehtabchi S, Sinert R, Baron BJ, et al. Does ethanol explain the acidosis commonly seen in ethanol-intoxicated patients? Clin Toxicol (Phila). 2005;43:161Y166.
41. Davis JW, Kaups KL, Parks SN. Effect of alcohol on the utility of base deficit in trauma. J Trauma. 1997;43:507Y510.
42. Dunham CM, Watson LA, Cooper C. Base deficit level indicating major injury is increased with ethanol. J Emerg Med. 2000;18:165Y171.
43. Zehtabchi S, Baron BJ, Sinert R, Yadav K, Lucchesi M. Ethanol and illicit drugs do not affect the diagnostic utility of base deficit and lactate in differentiating minor from major injury in trauma patients. Acad Emerg Med. 2004;11:1014Y1020.
44. Mentel A, Bach F, Schuler J, et al. Assessing errors in the determination of base excess. Anesth Analg. 2002;94:1141Y1148.
45. Oh MS, Uribarri J,Weinstein J, et al. What unique acid-base considerations exist in dialysis patients? Semin Dialysis. 17:351Y354.
46. Siggaard-Andersen O, Fogh-Andersen N. Base excess or buffer base (strong ion difference) as measure of a non-respiratory acid-base disturbance. Acta Anaesthesiol Scand Suppl. 1995;107:123Y128.