Alactic base excess (ABE): a novel internal milieu parameter-its concept and clinical importance

Area of Science:

• Critical Care Medicine
• Nephrology
• Biochemistry

Background:

• The Stewart-Figge approach provides a framework for understanding acid-base disorders.
• Alactic base excess (ABE) is a novel parameter derived from standard base excess and lactate levels.
• ABE aims to distinguish metabolic acidosis due to lactate accumulation from that caused by fixed acid retention (e.g., renal failure).

Purpose of the Study:

• To introduce and define alactic base excess (ABE) as a clinical parameter.
• To evaluate the utility of ABE in assessing acid-base status and renal function in sepsis.
• To determine the prognostic value of ABE in septic patients.

Main Methods:

• Calculation of ABE as the sum of lactate and standard base excess.
• Analysis of ABE values in the context of sepsis and metabolic acidosis.
• Correlation of ABE levels with renal dysfunction and patient mortality.

Main Results:

• A negative ABE value (<-3 mmol/L) serves as an early indicator of renal dysfunction in sepsis.
• Negative ABE significantly correlates with increased mortality rates in septic patients.
• ABE provides a clearer interpretation of acid-base disturbances compared to standard base excess alone.

Conclusions:

• ABE is a simple yet valuable tool for interpreting acid-base status in sepsis.
• ABE aids in assessing renal function and predicting prognosis in septic patients.
• Clinical integration of ABE can lead to more personalized and effective treatment strategies for sepsis.