Dear Martin
Derived acid base units are based on false assumptions and in the views of
many people are obsolete. It happens that they are easy to calculate (and
thus attractive to the designers of instruments) and apparently 'solve' the
problem of differentiating between respiratory and non-respiratory
contributions to acid base disturbances.
if bicarbonate is required in patients with acute non-respiratory acidosis
(it may be appropriate if there is evidence of cardiovascular dysfunction
but rarely unless hydrogen ion concentration is greater than 100 nmol/L, it
shoud be given in small aliquots and the results assessed by measuring
hydrogen ion concentration. Attempting to 'correct' a base deficit by the
infusion of bicarbonate in amounts calculated on the basis of derived
measurements is hazardous indeed.
All good wishes.
William
>Following discussions with one of our physicians I would be interested in
views on the following. Is base excess still a useful parameter to report
and how helpful is it in calculating the amount of bicarbonate to give to
correct metabolic acidosis?
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