[Base excess. Parameter with exceptional clinical significance].
The base excess of blood (BE) plays an important role in the description of the acid-base status of a patient and is gaining in clinical interest. Apart from the Quick test, the age, the injury severity score and the Glasgow coma scale, the BE is becoming more and more important to identify, e. g. the risk of mortality for patients with multiple injuries. According to Zander the BE is calculated using the pH, pCO(2), haemoglobin concentration and the oxygen saturation of haemoglobin (sO(2)). The use of sO(2 )allows the blood gas analyser to determine only one value of BE, independent of the type of blood sample analyzed: arterial, mixed venous or venous. The BE and measurement of the lactate concentration (cLac) play an important role in diagnosing critically ill patients. In general, the change in BE corresponds to the change in cLac. If DeltaBE is smaller than DeltacLac the reason could be therapy with HCO(3)(-) but also with infusion solutions containing lactate. Physician are very familiar with the term BE, therefore, knowledge about an alkalizing or acidifying effect of an infusion solution would be very helpful in the treatment of patients, especially critically ill patients. Unfortunately, at present the description of an infusion solution with respect to BE has not yet been accepted by the manufacturers.
Schaffartzik
W
W
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Unfallkrankenhaus Berlin, Warener Strasse 7, 12683 Berlin, Deutschland. Walter.Schaffartzik@ukb.de
D000137:Acid-Base Imbalance / Q000503:physiopathology*; D000468:Alkalies / Q000097:blood; D001784:Blood Gas Analysis; D016638:Critical Illness; D004912:Erythrocytes / Q000378:metabolism; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects; D019344:Lactic Acid / Q000097:blood; D019999:Pharmaceutical Solutions / Q000008:administration & dosage / Q000737:chemistry; D011379:Prognosis
D000468:Alkalies; D019999:Pharmaceutical Solutions; D019344:Lactic Acid