> At the risk of being branded a heretic, I have to admit that I still lok
> at the Base Excess or Standard Bicarbonate in some situations.
> I have seen "Chemists" of all grades look at a set of blood gas results
> with a low pH, raised Actual Bicarbonate and raised pCO2 and say that the
> raised Bicarbonate is due to metabolic compensation so this is chronic as
> opposed to acute respiratory failure.
>
> I know we should be able to work out what proportion of the bicarbonate is
> due to CO2 retention as opposed to metabolic compensation. And yes this
> is much easier if the hydrogen ion concentration is expressed in nmol/l.
> But it is a bit like CK slopes - a good way of diagnosing MI, but in the
> real world not many people can work out log slopes in their head so they
> still get the diagnosis wrong.
> Can someone re-educate me? I know there are problems with derived units
> so I would love to be able to tell people that they don't need to bother
> about them. But I am not convinced that this would necessarily improve
> management.
>
> Graham Ball
> Chelsea & Westminster
>
>
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