Umbilical artery base deficit/excess: sailing blindly in a thick fog

Area of Science:

• Neonatal physiology
• Clinical chemistry
• Medical diagnostics

Background:

• Base deficit (BD) is commonly used to assess newborn wellbeing at birth.
• Clinicians' understanding of BD concepts and laboratory result validity is often limited.
• Inconsistencies in BD calculation equations and disregard for neonatal acid-base physiology raise validity concerns.

Discussion:

• The evidence supporting specific BD thresholds for clinical decision-making in newborns is insufficient.
• Current practice guidelines relying on BD may require revision due to physiological and methodological limitations.
• Lack of standardized BD interpretation contributes to uncertainty in clinical practice.

Key Insights:

• BD calculations vary, and existing methods may not accurately reflect neonatal acid-base status.
• Insufficient evidence exists for established BD thresholds, hindering reliable clinical application.
• There is a critical need to address the validity and interpretation of BD in neonatal care.

Outlook:

• Future guidelines should incorporate validated methods for assessing neonatal acid-base balance.
• Further research is essential to establish reliable BD thresholds and improve diagnostic accuracy.
• Enhanced understanding and standardized protocols for BD assessment are crucial for optimal newborn care.