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Base excess

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1169:, hence respiratory acidosis; the kidneys then attempt to compensate for the low pH by raising blood bicarbonate. The kidneys only partially compensate, so the patient may still have a low blood pH, i.e. acidemia. In summary, the kidneys partially compensate for respiratory acidosis by raising blood bicarbonate. 790: 1115: 98:. Thus, a deviation of serum bicarbonate from the reference range is ordinarily mirrored by a deviation in base excess. However, base excess is a more comprehensive measurement, encompassing all metabolic contributions. 82:
defines the respiratory component of acid–base balance, base excess defines the metabolic component. Accordingly, measurement of base excess is defined, under a standardized pressure of carbon dioxide, by
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present in the blood. The value is usually reported as a concentration in units of mEq/L (mmol/L), with positive numbers indicating an excess of base and negative a deficit. A typical
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Base excess is defined as the amount of strong acid that must be added to each liter of fully oxygenated blood to return the pH to 7.40 at a temperature of 37°C and a pCO
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of 40 mmHg (5.3 kPa). A base deficit (i.e., a negative base excess) can be correspondingly defined by the amount of strong base that must be added.
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Base deficit with normal anion gap indicates loss of bicarbonate (e.g., diarrhea). The anion gap is maintained because bicarbonate is exchanged for
1158:). Often a disturbance in one triggers a partial compensation in the other. A secondary (compensatory) process can be readily identified because it 1878: 626:
Base excess (or deficit) is one of several values typically reported with arterial blood gas analysis that is derived from other measured data.
2447: 1871: 1441: 208: 1208:, usually involves either excretion of bicarbonate or neutralization of bicarbonate by excess organic acids. Common causes include 799: 1488: 1363: 1335: 1150:
Blood pH is determined by both a metabolic component, measured by base excess, and a respiratory component, measured by PaCO
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is useful for determining whether a base deficit is caused by addition of acid or loss of bicarbonate.
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Comparison of the base excess with the reference range assists in determining whether an
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Base deficit with elevated anion gap indicates addition of acid (e.g., ketoacidosis).
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is caused by a respiratory, metabolic, or mixed metabolic/respiratory problem. While
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For example, inadequate ventilation, a respiratory problem, causes a buildup of CO
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is at 5 g/dl. The latter gives a better view of the base excess of the entire
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A further distinction can be made between actual and standard base excess:
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Medical Calculators > Calculated Bicarbonate & Base Excess
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with units of mEq/L. The same can be alternatively expressed as
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refer to an excess or deficit, respectively, in the amount of
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The term and concept of base excess were first introduced by
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Frances Talaska Fischbach; Marshall Barnett Dunning (2008),
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Steven Pon, MD, Weill Medical College of Cornell University
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with renal compensation if too high (more than +2 mEq/L)
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with renal compensation if too low (less than −2 mEq/L)
650: 88: 1893: 1023: 919: 802: 661: 1250:, in which large amounts of bicarbonate are excreted 94:
The predominant base contributing to base excess is
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Excess or deficit in amount of base present in blood
1204:A base deficit (a below-normal base excess), thus 1109: 1003: 895: 784: 1190:Excessive loss of HCl in gastric acid by vomiting 1125:Base excess beyond the reference range indicates 2434: 611:base excess is that present in the blood, while 1193:Renal overproduction of bicarbonate, in either 1410:Anthology on Base Excess (O.Siggaard-Andersen) 1879: 1435: 1354:Jonathan D. Kibble; Colby R. Halsey (2009), 1328:A Manual of Laboratory and Diagnostic Tests 1886: 1872: 1442: 1428: 1349: 1347: 561: 451: 389: 349: 295: 245: 188: 117: 14: 2435: 1383: 645:Base excess can be estimated from the 1867: 1423: 1344: 1004:{\displaystyle pH=pK+log{\frac {}{}}} 1162:the observed deviation in blood pH. 2184:Glycogen phosphorylase isoenzyme BB 1356:Medical Physiology: The Big Picture 71:for base excess is −2 to +2 mEq/L. 24: 2448:Diagnostic intensive care medicine 615:base excess is the value when the 25: 2459: 1398: 1221:, in which high levels of acidic 1120: 1379:Acid-Base Tutorial — Terminology 1176:, usually involves an excess of 1833:Fractional excretion of sodium 1372: 1319: 1081: 1066: 1014:Ultimately the end result is: 995: 979: 974: 950: 906:Calculations are based on the 869: 845: 13: 1: 2141:Comprehensive metabolic panel 1330:(8th ed.), p. 973, 1313: 1253:Ingestion of poisons such as 640: 101: 87:back to a standardized blood 7: 2077:Thyroid-stimulating hormone 2039:Total iron-binding capacity 1811:Effective renal plasma flow 1655:Intracellular fluid/Cytosol 10: 2464: 2418:Elevated alpha-fetoprotein 1760:Glomerular filtration rate 1752:Assessment and measurement 1615:Atrial natriuretic peptide 1415:Emedicine: Lactic Acidosis 2410: 2370: 2363: 2333: 2310: 2301: 2271: 2192: 2149: 2087: 2057: 2014: 1967: 1902: 1843:Tubuloglomerular feedback 1825: 1770:Augmented renal clearance 1750: 1727:Bicarbonate buffer system 1685: 1643: 1597: 1590: 1548: 1502: 1471: 1461: 1451:Physiology of the kidneys 1235:during heavy exercise or 1212:Compensation for primary 1184:Compensation for primary 1172:A high base excess, thus 149: 37: 32: 1732:Respiratory compensation 1489:Clearance of medications 1947:BUN-to-creatinine ratio 1838:BUN-to-creatinine ratio 1573:Countercurrent exchange 2380:Elevated transaminases 2072:Thyroid function tests 2034:Transferrin saturation 1894:Clinical biochemistry 1287: 1242:Chronic kidney failure 1180:. It can be caused by 1111: 1005: 897: 786: 2174:Lactate dehydrogenase 2136:Basic metabolic panel 2067:ACTH stimulation test 1775:Renal clearance ratio 1694:Darrow Yannet diagram 1294:Acid–base homeostasis 1219:Diabetic ketoacidosis 1214:respiratory alkalosis 1195:contraction alkalosis 1154:(partial pressure of 1144:respiratory alkalosis 1112: 1006: 908:Henderson-Hasselbalch 898: 787: 649:concentration () and 635:Ole Siggaard-Andersen 76:acid/base disturbance 2194:Liver function tests 2049:Transferrin receptor 1800:Hemodialysis product 1780:Urea reduction ratio 1765:Creatinine clearance 1605:Antidiuretic hormone 1455:acid–base physiology 1233:anaerobic metabolism 1186:respiratory acidosis 1134:respiratory acidosis 1021: 917: 800: 659: 462:LIVER FUNCTION TESTS 2210:Serum total protein 2205:Human serum albumin 1676:Transcellular fluid 1660:Extracellular fluid 1578:Filtration fraction 1303:Metabolic alkalosis 1174:metabolic alkalosis 1130:metabolic alkalosis 973: 868: 734: 621:extracellular fluid 114: 2443:Chemical pathology 1982:Arterial blood gas 1737:Renal compensation 1666:Interstitial fluid 1308:Arterial blood gas 1299:Metabolic acidosis 1206:metabolic acidosis 1140:metabolic acidosis 1107: 1001: 959: 893: 854: 782: 720: 191:ARTERIAL BLOOD GAS 107: 2430: 2429: 2426: 2425: 2359: 2358: 2312:Blood sugar level 2291:Pancreatic lipase 2129:Total cholesterol 1959:Serum osmolal gap 1954:Plasma osmolality 1861: 1860: 1795:Dialysis adequacy 1790:Standardized Kt/V 1746: 1745: 1704:Davenport diagram 1687:Acid–base balance 1586: 1585: 1563:Renal plasma flow 1365:978-0-07-164302-3 1337:978-0-7817-7194-8 1283:during excretion. 1199:Cushing's disease 999: 817: 676: 653:by the equation: 597: 596: 49: 48: 16:(Redirected from 2455: 2402:Hyperproteinemia 2368: 2367: 2308: 2307: 1888: 1881: 1874: 1865: 1864: 1816:Extraction ratio 1719:Winters' formula 1595: 1594: 1558:Renal blood flow 1484:Pharmacokinetics 1469: 1468: 1444: 1437: 1430: 1421: 1420: 1393: 1387: 1381: 1376: 1370: 1369: 1351: 1342: 1341: 1323: 1116: 1114: 1113: 1108: 1085: 1084: 1057: 1056: 1010: 1008: 1007: 1002: 1000: 998: 994: 993: 977: 972: 967: 948: 902: 900: 899: 894: 867: 862: 815: 791: 789: 788: 783: 781: 777: 776: 772: 739: 735: 733: 728: 674: 352:SERUM OSMOLARITY 161: 152: 115: 106: 30: 29: 21: 2463: 2462: 2458: 2457: 2456: 2454: 2453: 2452: 2433: 2432: 2431: 2422: 2406: 2395:Hypoalbuminemia 2390:Hypoproteinemia 2355: 2329: 2303:Small molecules 2297: 2267: 2188: 2145: 2083: 2053: 2010: 2000: 1963: 1898: 1892: 1862: 1857: 1821: 1742: 1681: 1639: 1591:Other functions 1582: 1568:Ultrafiltration 1544: 1498: 1494:Urine flow rate 1457: 1448: 1401: 1396: 1388: 1384: 1377: 1373: 1366: 1358:, p. 249, 1352: 1345: 1338: 1324: 1320: 1316: 1290: 1261:, or excessive 1259:ethylene glycol 1229:Lactic acidosis 1168: 1153: 1123: 1065: 1061: 1052: 1048: 1022: 1019: 1018: 989: 985: 978: 968: 963: 949: 947: 918: 915: 914: 904: 863: 858: 801: 798: 797: 759: 755: 729: 724: 713: 709: 708: 704: 660: 657: 656: 643: 603: 598: 319: 283: 278: 268: 263: 233: 228: 218: 213: 203: 176: 159: 158: 153: 150: 109:Pathophysiology 104: 69:reference range 28: 23: 22: 15: 12: 11: 5: 2461: 2451: 2450: 2445: 2428: 2427: 2424: 2423: 2421: 2420: 2414: 2412: 2408: 2407: 2405: 2404: 2399: 2398: 2397: 2387: 2382: 2376: 2374: 2365: 2361: 2360: 2357: 2356: 2354: 2353: 2348: 2343: 2337: 2335: 2331: 2330: 2328: 2327: 2322: 2316: 2314: 2305: 2299: 2298: 2296: 2295: 2294: 2293: 2283: 2277: 2275: 2269: 2268: 2266: 2265: 2264: 2263: 2258: 2248: 2243: 2242: 2241: 2236: 2231: 2219: 2214: 2213: 2212: 2207: 2198: 2196: 2190: 2189: 2187: 2186: 2181: 2176: 2171: 2166: 2161: 2159:Cardiac marker 2155: 2153: 2151:Cardiovascular 2147: 2146: 2144: 2143: 2138: 2133: 2132: 2131: 2126: 2121: 2116: 2106: 2105: 2104: 2102:Hemoglobin A1c 2093: 2091: 2085: 2084: 2082: 2081: 2080: 2079: 2069: 2063: 2061: 2055: 2054: 2052: 2051: 2046: 2041: 2036: 2031: 2026: 2020: 2018: 2012: 2011: 2009: 2008: 2003: 1998: 1994: 1989: 1984: 1979: 1973: 1971: 1965: 1964: 1962: 1961: 1956: 1951: 1950: 1949: 1944: 1939: 1932:Renal function 1929: 1924: 1919: 1914: 1908: 1906: 1900: 1899: 1891: 1890: 1883: 1876: 1868: 1859: 1858: 1856: 1855: 1850: 1845: 1840: 1835: 1829: 1827: 1823: 1822: 1820: 1819: 1813: 1804: 1803: 1802: 1792: 1787: 1782: 1777: 1772: 1767: 1762: 1756: 1754: 1748: 1747: 1744: 1743: 1741: 1740: 1739: 1734: 1729: 1721: 1716: 1706: 1701: 1696: 1691: 1689: 1683: 1682: 1680: 1679: 1673: 1668: 1662: 1649: 1647: 1641: 1640: 1638: 1637: 1635:Prostaglandins 1632: 1627: 1625:Erythropoietin 1622: 1617: 1612: 1607: 1601: 1599: 1592: 1588: 1587: 1584: 1583: 1581: 1580: 1575: 1570: 1565: 1560: 1554: 1552: 1546: 1545: 1543: 1542: 1537: 1532: 1527: 1522: 1517: 1512: 1506: 1504: 1500: 1499: 1497: 1496: 1491: 1486: 1481: 1475: 1473: 1466: 1459: 1458: 1447: 1446: 1439: 1432: 1424: 1418: 1417: 1412: 1407: 1400: 1399:External links 1397: 1395: 1394: 1382: 1371: 1364: 1343: 1336: 1317: 1315: 1312: 1311: 1310: 1305: 1296: 1289: 1286: 1285: 1284: 1277: 1266: 1265: 1251: 1245: 1239: 1226: 1216: 1202: 1201: 1191: 1188: 1166: 1156:carbon dioxide 1151: 1148: 1147: 1137: 1122: 1121:Interpretation 1119: 1118: 1117: 1106: 1103: 1100: 1097: 1094: 1091: 1088: 1083: 1080: 1077: 1074: 1071: 1068: 1064: 1060: 1055: 1051: 1047: 1044: 1041: 1038: 1035: 1032: 1029: 1026: 1012: 1011: 997: 992: 988: 984: 981: 976: 971: 966: 962: 958: 955: 952: 946: 943: 940: 937: 934: 931: 928: 925: 922: 892: 889: 886: 883: 880: 877: 874: 871: 866: 861: 857: 853: 850: 847: 844: 841: 838: 835: 832: 829: 826: 823: 820: 814: 811: 808: 805: 780: 775: 771: 768: 765: 762: 758: 754: 751: 748: 745: 742: 738: 732: 727: 723: 719: 716: 712: 707: 703: 700: 697: 694: 691: 688: 685: 682: 679: 673: 670: 667: 664: 642: 639: 601: 595: 594: 588: 582: 576: 569: 568: 559: 558: 552: 550: 544: 537: 536: 530: 524: 522: 519: 518: 512: 506: 500: 493: 492: 486: 480: 474: 467: 466: 449: 448: 442: 436: 430: 423: 422: 416: 410: 404: 397: 396: 387: 386: 380: 374: 368: 361: 360: 347: 346: 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2162: 2160: 2157: 2156: 2154: 2152: 2148: 2142: 2139: 2137: 2134: 2130: 2127: 2125: 2124:Triglycerides 2122: 2120: 2117: 2115: 2112: 2111: 2110: 2107: 2103: 2100: 2099: 2098: 2097:Blood glucose 2095: 2094: 2092: 2090: 2086: 2078: 2075: 2074: 2073: 2070: 2068: 2065: 2064: 2062: 2060: 2056: 2050: 2047: 2045: 2042: 2040: 2037: 2035: 2032: 2030: 2027: 2025: 2022: 2021: 2019: 2017: 2013: 2007: 2004: 2002: 1995: 1993: 1990: 1988: 1985: 1983: 1980: 1978: 1975: 1974: 1972: 1970: 1966: 1960: 1957: 1955: 1952: 1948: 1945: 1943: 1940: 1938: 1935: 1934: 1933: 1930: 1928: 1925: 1923: 1920: 1918: 1915: 1913: 1910: 1909: 1907: 1905: 1901: 1897: 1889: 1884: 1882: 1877: 1875: 1870: 1869: 1866: 1854: 1851: 1849: 1846: 1844: 1841: 1839: 1836: 1834: 1831: 1830: 1828: 1824: 1817: 1814: 1812: 1808: 1807:PAH clearance 1805: 1801: 1798: 1797: 1796: 1793: 1791: 1788: 1786: 1783: 1781: 1778: 1776: 1773: 1771: 1768: 1766: 1763: 1761: 1758: 1757: 1755: 1753: 1749: 1738: 1735: 1733: 1730: 1728: 1725: 1724: 1722: 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1210: 1209: 1207: 1200: 1196: 1192: 1189: 1187: 1183: 1182: 1181: 1179: 1175: 1170: 1163: 1161: 1157: 1145: 1141: 1138: 1135: 1131: 1128: 1127: 1126: 1104: 1101: 1098: 1095: 1092: 1089: 1086: 1078: 1075: 1072: 1069: 1062: 1058: 1053: 1049: 1045: 1042: 1039: 1036: 1033: 1030: 1027: 1024: 1017: 1016: 1015: 990: 986: 982: 969: 964: 960: 956: 953: 944: 941: 938: 935: 932: 929: 926: 923: 920: 913: 912: 911: 909: 903: 890: 887: 884: 881: 878: 875: 872: 864: 859: 855: 851: 848: 842: 839: 836: 833: 830: 827: 824: 821: 818: 812: 809: 806: 803: 795: 792: 778: 773: 769: 766: 763: 760: 756: 752: 749: 746: 743: 740: 736: 730: 725: 721: 717: 714: 710: 705: 701: 698: 695: 692: 689: 686: 683: 680: 677: 671: 668: 665: 662: 654: 652: 648: 638: 636: 632: 627: 624: 622: 618: 614: 610: 605: 592: 589: 586: 583: 580: 577: 574: 571: 570: 567: 565: 560: 556: 553: 551: 548: 545: 542: 539: 538: 534: 531: 528: 525: 523: 521: 520: 516: 513: 510: 507: 504: 501: 498: 495: 494: 490: 487: 484: 481: 478: 475: 472: 469: 468: 465: 463: 459: 455: 450: 446: 443: 440: 437: 434: 431: 428: 425: 424: 420: 417: 414: 411: 408: 405: 402: 399: 398: 395: 393: 388: 384: 381: 378: 375: 372: 369: 366: 363: 362: 359: 357: 353: 348: 345: 342: 339: 336: 333: 330: 327: 326: 323: 320: 314: 311: 308: 305: 302: 301: 298: 294: 290: 287: 284: 275: 272: 269: 260: 257: 255: 254: 251: 249: 244: 240: 237: 234: 225: 222: 219: 210: 207: 204: 198: 197: 194: 192: 187: 183: 180: 177: 171: 168: 165: 164: 156: 146: 143: 140: 137: 134: 131: 130: 127: 125: 121: 116: 113: 112:sample values 110: 99: 97: 92: 90: 86: 81: 77: 72: 70: 66: 62: 58: 54: 45: 42: 40: 36: 31: 19: 2385:Elevated ALP 2351:Hypouricemia 2320:Hypoglycemia 2256:Unconjugated 2221: 1986: 1904:Electrolytes 1698: 1510:Solvent drag 1503:Reabsorption 1385: 1374: 1355: 1327: 1321: 1267: 1225:are produced 1203: 1171: 1164: 1159: 1149: 1124: 1013: 905: 796: 793: 655: 644: 628: 625: 612: 608: 606: 599: 562: 452: 390: 350: 334: 296: 248:ALVEOLAR GAS 246: 189: 124:ELECTROLYTES 118: 93: 73: 61:base deficit 60: 56: 50: 18:Base deficit 2334:Nitrogenous 2169:CPK-MB test 2109:Lipid panel 2044:Transferrin 1992:Bicarbonate 1987:Base excess 1896:blood tests 1848:Natriuresis 1713:Delta ratio 1699:Base excess 1610:Aldosterone 1178:bicarbonate 647:bicarbonate 631:Poul Astrup 96:bicarbonate 57:base excess 33:Base excess 2437:Categories 2261:Conjugated 2089:Metabolism 2029:Serum iron 2016:Iron tests 1937:Creatinine 1723:Buffering 1651:Body water 1630:Calcitriol 1550:Filtration 1314:References 1268:The serum 910:equation: 641:Estimation 617:hemoglobin 392:URINALYSIS 102:Definition 53:physiology 2251:Bilirubin 2201:Proteins 2179:Myoglobin 1977:Anion gap 1969:Acid-base 1917:Potassium 1709:Anion gap 1479:Clearance 1472:Secretion 1462:Creating 1270:anion gap 1231:, due to 1102:− 1093:× 1076:− 1059:× 1037:× 970:− 888:− 879:× 865:− 843:× 767:− 753:× 741:− 731:− 702:× 637:in 1958. 591:CSF/S glu 585:CSF/S alb 91:of 7.40. 85:titrating 2364:Proteins 2341:Azotemia 2273:Pancreas 2059:Hormones 2024:Ferritin 1922:Chloride 1598:Hormones 1520:Chloride 1281:chloride 1255:methanol 1248:Diarrhea 613:standard 337:= −0.36 2281:Amylase 2006:Lactate 2001:content 1927:Calcium 1540:Protein 1530:Glucose 1263:aspirin 1237:hypoxia 1160:opposes 1034:0.02786 579:CSF glu 573:CSF alb 527:AST/ALT 454:PROTEIN 435:= 1.01 421:= 0.95 367:= 300 241:= 7.40 44:11555-0 2286:Lipase 1912:Sodium 1671:Plasma 1515:Sodium 1362:  1334:  1105:124.58 891:124.58 816:  675:  609:actual 593:= 0.6 587:= 7.5 549:= 1.0 543:= 3.0 541:AF alb 535:= 0.2 529:= 0.6 517:= 0.5 505:= 4.0 491:= 0.7 479:= 7.6 473:= 100 447:= 800 409:= 100 383:BUN:Cr 373:= 295 312:= 2.0 306:= 9.5 297:OTHER: 285:= 105 184:= 1.0 141:= 100 135:= 140 2411:Other 1853:Urine 1826:Other 1620:Renin 1464:urine 1142:, or 1132:, or 1090:13.77 876:13.77 581:= 60 575:= 30 557:= 60 511:= 40 499:= 71 485:= 25 441:= 60 429:= 25 403:= 80 385:= 20 356:RENAL 343:= 16 331:= 55 291:= 10 289:A-a g 270:= 36 235:= 95 220:= 40 205:= 24 178:= 22 157:= 150 147:= 20 39:LOINC 1942:Urea 1785:Kt/V 1525:Urea 1453:and 1360:ISBN 1332:ISBN 840:0.93 750:14.8 744:24.4 699:0.93 633:and 547:SAAG 489:TBIL 419:FENa 415:= 5 379:= 5 321:= 1 169:= 4 65:base 59:and 2372:LFT 2246:GGT 2234:AST 2229:ALT 2217:ALP 2119:HDL 2114:LDL 1288:See 1197:or 1079:6.1 770:7.4 564:CSF 555:SOG 509:ALT 503:Alb 497:ALP 483:AST 471:LDH 439:UCr 433:USG 413:UAG 407:UCl 401:UNa 377:POG 371:PCO 365:PMO 200:HCO 182:PCr 155:Glu 145:BUN 120:BMP 51:In 2439:: 1997:CO 1653:: 1346:^ 1301:/ 1257:, 1063:10 651:pH 623:. 533:BU 515:BC 477:TP 458:GI 445:UO 427:UK 341:AG 335:BE 329:CK 316:PO 310:Mg 304:Ca 265:CO 239:pH 215:CO 173:CO 139:Cl 133:Na 89:pH 55:, 1999:2 1887:e 1880:t 1873:v 1818:) 1809:( 1715:) 1711:( 1678:) 1664:( 1443:e 1436:t 1429:v 1368:. 1340:. 1167:2 1152:2 1099:H 1096:p 1087:+ 1082:) 1073:H 1070:p 1067:( 1054:2 1050:O 1046:C 1043:a 1040:P 1031:= 1028:E 1025:B 996:] 991:2 987:O 983:C 980:[ 975:] 965:3 961:O 957:C 954:H 951:[ 945:g 942:o 939:l 936:+ 933:K 930:p 927:= 924:H 921:p 885:H 882:p 873:+ 870:] 860:3 856:O 852:C 849:H 846:[ 837:= 834:s 831:s 828:e 825:c 822:x 819:e 813:e 810:s 807:a 804:B 779:) 774:) 764:H 761:p 757:( 747:+ 737:] 726:3 722:O 718:C 715:H 711:[ 706:( 696:= 693:s 690:s 687:e 684:c 681:x 678:e 672:e 669:s 666:a 663:B 602:2 566:: 464:: 460:/ 456:/ 394:: 358:: 354:/ 318:4 282:2 280:O 277:A 274:p 267:2 262:A 259:p 250:: 232:2 230:O 227:a 224:p 217:2 212:a 209:p 202:3 193:: 175:2 167:K 160:\ 151:/ 126:: 122:/ 20:)

Index

Base deficit
LOINC
11555-0
physiology
base
reference range
acid/base disturbance
carbon dioxide
titrating
pH
bicarbonate
Pathophysiology
sample values
BMP
ELECTROLYTES
Na
Cl
BUN
Glu
K
CO2
PCr
ARTERIAL BLOOD GAS
HCO3
p
CO2
p
O2
pH
ALVEOLAR GAS

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