title: Neonatal metabolic acidosis at birth: In search of a reliable marker.
abstract: OBJECTIVE
  A newborn may present acidemia on the umbilical artery blood which can result from respiratory acidosis or metabolic acidosis or be of mixed origin. Currently, in the absence of a satisfactory definition, the challenge is to determine the most accurate marker for metabolic acidosis, which can be deleterious for the neonate.
  
  
  METHODS
  We reviewed the methodological and physiological aspects of the perinatal literature to search for the best marker of NMA.
  
  
  RESULTS
  Base deficit and pH have been criticized as the standard criteria to predict outcome. The proposed threshold of pathogenicity is not based on convincing studies. The algorithms of various blood gas analyzers differ and do not take into account the specific neonatal acid-base profile.
  
  
  CONCLUSIONS
  Birth-related neonatal eucapnic pH is described as the most pertinent marker of NMA at birth. The various means of calculating this value and the level below which it seems to play a possible pathogenic role are presented.
authors.affiliation: UGA Grenoble, Domaine Universitaire, 621, avenue Centrale, 38400 Saint-Martin-d'Hères, France; Childhood Disabilities and Perinatal Data Register (RHEOP), 23, avenue Albert-1(er)-de-Belgique, 38000 Grenoble, France. Electronic address: claude.racinet@orange.fr.
authors.forename: C
authors.initials: C
authors.lastname: Racinet
authors.affiliation: Department of Surgery, Sherbrooke University, Sherbrooke, Quebec, Canada; Vitality Health Care Network, zone 4, Edmundston, New Brunswick, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Ouellet
authors.affiliation: Regional Hospital Center of Toulon-La Seyne/Mer, Toulon, France.
authors.forename: F
authors.initials: F
authors.lastname: Charles
authors.affiliation: University of Ottawa, Ottawa, Canada; Department of Pediatrics, Children's Hospital of East Ontario, Ottawa, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Daboval
mesh_terms: D000136:Acid-Base Equilibrium; D000138:Acidosis / Q000097:blood*; D000465:Algorithms; D015415:Biomarkers / Q000097:blood*; D001784:Blood Gas Analysis; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D012016:Reference Values
chemical_list: D015415:Biomarkers
keywords: Acidose métabolique; Acidose respiratoire; Birth-related eucapnic neonatal pH; Metabolic acidosis; Neonate; Nouveau-né; PH eucapnique néonatal à la naissance; Respiratory acidosis