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The application of the extracellular base excess to children
Abstract:
The Base Excess of the Extracellular Fluid (BE-ecf) is the most complete model of acid-base physiology. It has gained considerable acceptance for use in adults as an index of the metabolic component of an acute acid-base disturbance. Several other commonly used indices were compared to the BE-ecf. The values of the Base Excess of Blood, Plasma Bicarbonate, Standard Bicarbonate, and T40-Bicarbonate differed significantly from the BE-ecf in 11.4, 6.3, 12.5, and 1.1% of samples, respectively. These differences are considered to be errors since the nonlinear relationship of the variables makes it difficult to clinically accommodate them. The standard (adult) form of the BE-ecf calculation overestimated the base excess by 1 meq/liter in 44.8% and by 2 meq/liter or more in 6.1% of samples from neonates and infants when compared to a form of the calculation which was individually adjusted based on the weight and hemoglobin concentration of each subject. Since it is no more difficult to make these corrections than to ignore them, if the BE-ecf is to be used in neonates and infants the correction should be applied.
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