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Related Experiment Videos

[Base excess] vs [strong ion difference]. Which is more helpful?

R Schlichtig1

  • 1Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh, V.A. Medical Center, Pennsylvania 15240, USA.

Advances in Experimental Medicine and Biology
|January 1, 1997
PubMed
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Base excess (BE) may be misleading in complex acid-base disturbances. Strong ion difference excess (SIDEx) offers a more accurate physiological assessment than standard strong ion difference (SID) alone.

Area of Science:

  • Physiology
  • Biochemistry
  • Medical Diagnostics

Background:

  • The traditional base excess (BE) metric for metabolic acid-base disturbances is criticized for inadequacy in complex cases.
  • The strong ion difference (SID) method is proposed as an alternative, but its relationship with BE in certain conditions remains unclear.
  • Hypoproteinemia has been observed with normal SID but elevated BE, posing a diagnostic challenge.

Purpose of the Study:

  • To test the hypothesis that strong ion difference (SID) equals strong ion difference excess (SIDEx) under normal physiological conditions.
  • To develop and validate a SIDEx formula analogous to the Siggaard-Andersen BE equation.
  • To compare SID and SIDEx across physiological ranges of plasma albumin, phosphate, and pH.

Main Methods:

Related Experiment Videos

  • Computer simulation was employed to test the hypothesis.
  • A novel SIDEx formula was derived based on the plasma SID equation: SIDEx = [HCO3-] - 24.72 + (pH - 7.4) * (1.159 * [alb] + 0.423 * [Pi]).
  • SID and SIDEx were compared across physiological variations in plasma albumin, phosphate, and pH.

    • Main Results:

    • The hypothesis that SID equals SIDEx was refuted.
    • SIDEx demonstrated a variation of approximately 15 mM at any given SID.
    • A normal SID was observed concurrently with an elevated SIDEx.

    Conclusions:

    • Strong ion difference (SID) can appear normal even when strong ion difference excess (SIDEx) is elevated.
    • SIDEx is a more accurate physiological reflection of base excess (BE) than SID alone.
    • SIDEx provides a more helpful quantity for understanding complex acid-base disturbances in physiology.