Base excess (BE): reloaded.

Area of Science:

• Biochemistry
• Clinical Chemistry
• Critical Care Medicine

Background:

• Base excess (BE) is a vital parameter in clinical diagnostics.
• Distinguishing BE from standard base excess (SBE) is critical for accurate interpretation.
• BE has demonstrated significant clinical utility since 2007.

Purpose of the Study:

• To emphasize the diagnostic and therapeutic importance of correctly calculated base excess (BE).
• To differentiate the application of BE in vivo and in vitro (as BEpot).
• To highlight the minimal sample volume required for optimal BE assessment.

Main Methods:

• Calculation of base excess (BE) using pH, pCO2, sO2, and cHb values.
• Application of BE for in vivo diagnostics (e.g., mortality, acidosis, bleeding).
• Application of potential base excess (BEpot) for in vitro assessments (e.g., solutions, blood products).

Main Results:

• Correctly calculated BE serves as a diagnostic tool for diverse in vivo events.
• BE is effective in diagnosing metabolic acidosis or alkalosis from small blood samples.
• BEpot is a valuable therapeutic tool for various in vitro assessments.

Conclusions:

• Base excess (BE), not SBE, is the correct parameter for clinical assessment.
• BE is essential for diagnosing and managing acid-base balance in both physiological and artificial contexts.
• The clinical significance of BE and BEpot underscores their importance in modern medicine.