[Bedside interpretation of complex metabolic acid-base disturbances using standard base excess partitioning]

Metabolic acid-base disturbances often result from several independent processes. These processes are difficult to tease out using traditional bicarbonate-centred approaches. According to standard base excess partitioning, standard base excess is the sum of the acid-base effects of changes in the concentration of sodium, chloride, lactate, albumin and an unspecified entity termed »Other Ions«. Since the first five of these entities are routinely analysed, »Other Ions« can be calculated at the bedside. In this article, five short case vignettes are used to illustrate how standard base excess partitioning provides a more complete understanding of the patient's acid-base disturbance, and how it may allow for more physiologically appropriate therapy.