An overlooked aspect on metabolic acidosis at birth: Blood gas analyzers calculate base deficit differently

Mokarami, Parisa; Wiberg, Nana; Olofsson, Per

doi:10.1111/j.1600-0412.2011.01364.x

Cited by 27 publications

(19 citation statements)

References 22 publications

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“…Further, measuring the same samples in different gas analyzers yields different incidences of significant metabolic acidosis. 18 It is not entirely surprising that the degree of acidosis is more important than the degree of base deficit. It is largely the hydrogen ion concentration that is responsible for cellular damage; base deficit reflects the buffering process.…”

Section: Prediction Of Adverse Outcomesmentioning

confidence: 98%

The significance of base deficit in acidemic term neonates

Knutzen

Svirko

Impey

2015

American Journal of Obstetrics and Gynecology

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Section: Prediction Of Adverse Outcomesmentioning

confidence: 98%

The significance of base deficit in acidemic term neonates

Knutzen

Svirko

Impey

2015

American Journal of Obstetrics and Gynecology

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“…However, base excess is calculated differently by different blood gas analysers. 14,20 To control for any possible errors in interpreting actual base excess for standard base excess values, we calculated base excess in extracellular fluid-also known as standard base excess-post hoc from measured values of pH and pCO 2 . Thus, at least one source of possible error was eliminated.…”

Section: Discussionmentioning

confidence: 99%

Hypoxia with acidosis in extremely preterm born infants was not associated with an increased risk of death or impaired neurodevelopmental outcome at 6.5 years

et al. 2019

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Aim It is not clear whether perinatal acidosis can predict poor outcomes in extremely preterm infants and we investigated associations between intrapartum hypoxia and mortality and neurodevelopmental outcomes. Methods We used nationwide data on 705 infants from the Extremely Preterm Infants in Sweden Study, delivered at 22‐26 weeks of gestation during 2004‐2007. Comprehensive neurodevelopmental assessments were performed on survivors at 2.5 (n = 456) and 6.5 (n = 441) years of corrected age. Gestational age‐related changes in umbilical cord arterial pH were compared with reference values for term newborn infants, and base excess was also calculated. Associations between low blood gas values (<10th percentile) and mortality and neurodevelopmental outcome were estimated. Results Cord blood determination was more common in surviving infants (P < .001), with pH determined in 322/705 (46%) and base excess in 311/705 (44%). Extremely preterm infants had higher pH values than term infants (P < .0001), with no change from 22 to 26 weeks of gestation (P = .61, r2 = .001). Multiple logistic regression showed no association between low blood gas values and risk of death or neurodevelopmental impairment at 6.5 years (P ≥ .17). Conclusion Hypoxia with acidosis at birth was not associated with an increased risk of death or impaired neurodevelopmental in extremely preterm born children at 6.5 years.

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“…In Lund, the blood gas analyzer programmed to automatically calculate base deficit in extracellular fluid (BD ecf ) whilst in Malmö, the ABL was set to calculate base deficit (BD) in whole blood. Since the latter is known to introduce a serious confounding factor (11, 12), we standardized BD values to BD ecf post hoc using the algorithms in the ABL 800 manual: where “c” denotes concentration and “ctHb” denotes total concentration of hemoglobin …”

Section: Methodsmentioning

confidence: 99%

Maternal arterial blood values during delivery: effect of mode of delivery, maternal characteristics, obstetric interventions and correlation to fetal umbilical cord blood

Zaigham

Helfer

Kristensen

et al. 2020

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1 Maternal arterial blood values during delivery: effect of mode of delivery, maternal 2 characteristics, obstetric interventions and correlation to fetal umbilical cord blood 3 4 Mehreen Abstract 27 Objective 28 To determine a reference interval for maternal arterial blood values during vaginal delivery and 29 to elucidate the effect of common maternal characteristics and obstetric interventions on 30 maternal acid base values during vaginal and planned cesarean section (CS). 31 Design 32 Prospective, observational study of randomly selected women undergoing vaginal deliveries 33 and planned CS at Skåne University Hospital, Malmö, Sweden. Results35 Two hundred and fifty women undergoing vaginal delivery (VD) and fifty-eight women 36 undergoing planned CS were recruited. We found significant differences for gestational age, 37 parity, artery pH, pCO 2 , pO 2 , sO 2 and cord venous pH, pCO 2 and lactate between the two study 38 groups (P < 0.005). For women undergoing vaginal delivery, we found significant changes in 39 base deficit, hemoglobin, bilirubin, potassium, glucose and lactate values as compared to 40 women with planned CS (P < 0.02). Maternal characteristics did not significantly affect acid 41 base parameters however, multiple regression showed significant associations for the use of 42 epidural anesthesia on maternal pH (P < 0.05) and pO 2 (P < 0.01); and synthetic oxytocin on 43 pCO 2 (P = 0.08), glucose (P < 0.00) and lactate (P < 0.02) in maternal blood. Maternal arterial 44 pH, pCO 2 and lactate correlated significantly to values in venous umbilical cord blood (P < 45 0.000). Conclusions47 Reference values for maternal arterial blood gases in vaginal deliveries for term pregnancies 48 were outlined and we found that most arterial blood gas parameters varied significantly 3 49 according to mode of delivery. The use of different obstetrical interventions like epidural 50 anesthesia or synthetic oxytocin, resulted in significant changes in blood gas values. 51 Introduction52 It is well known that there are significant changes in almost all maternal organ systems during 53 pregnancy and that these physiological changes enable the mother to optimally nourish the fetus 54 as well as prepare her for labor (1). Klajnbard and Maguire (2, 3) showed large variations in 55 most maternal venous parameters during the three trimesters of pregnancy. Despite this 56 knowledge, obstetricians routinely use reference values from non-pregnant women to assess 57 the condition of the pregnant patient. Few studies have focused on physiological variations 58 during pregnancy and delivery, and arterial blood gases including electrolytes, bilirubin, 59 glucose and lactate have seldom been studied. In addition, the possible impact of mode of 60 delivery on different maternal and obstetric factors commonly encountered during delivery, has 61 not been studied.62 One of the most frequently encountered maternal risk factors during pregnancy and delivery is 63 obesity. Maternal obesity is associated with increased fat deposition,...

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An overlooked aspect on metabolic acidosis at birth: Blood gas analyzers calculate base deficit differently

Abstract: The neonatal metabolic acidosis rate varied significantly with blood gas analyzer brand and fetal fluid compartment for calculation of BD.

Cited by 27 publications

References 22 publications

The significance of base deficit in acidemic term neonates

The significance of base deficit in acidemic term neonates

Hypoxia with acidosis in extremely preterm born infants was not associated with an increased risk of death or impaired neurodevelopmental outcome at 6.5 years

Maternal arterial blood values during delivery: effect of mode of delivery, maternal characteristics, obstetric interventions and correlation to fetal umbilical cord blood

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