Base excess (BE): reloaded

Abstract

The base excess value (BE, mmol/L), not standard base excess (SBE), correctly calculated including pH, pCO₂ (mmHg), sO₂ (%) and cHb (g/dl) is a diagnostic tool for several in vivo events, e.g., mortality after multiple trauma or shock, acidosis, bleeding, clotting, artificial ventilation. In everyday clinical practice a few microlitres of blood (arterial, mixed venous or venous) are sufficient for optimal diagnostics of any metabolic acidosis or alkalosis.The same applies to a therapeutic tool-then referred to as potential base excess (BEpot)-for several in vitro assessments, e.g., solutions for infusion, sodium bicarbonate, blood products, packed red blood cells, plasma. Thus, BE or BEpot has been a parameter with exceptional clinical significance since 2007.

Keywords: Acidosis; Artificial ventilation; Base excess; Bleeding; Blood products; Infusion solutions; Intensive care diagnostic; Mortality; Potential base excess; Shock.

Fig. 1

[taken from18] Mortality vs. base excess (BE) in multiple trauma patients: Correlation between mortality (%) and base excess (mmol/L) on hospital admission and 24 h thereafter * in a population of approximately 8200 patients selected from about 15,300 patients [80, 321,326, 347]

Fig. 2

[taken from18] Negative base excess (mmol/L during storage of packed red cell (PRC) or whole blood (WB) units with and without leukocyte depletion [20]