Umbilical artery base deficit/excess: sailing blindly in a thick fog

Abstract

Assessing the wellbeing of newborns at birth with base deficit (BD)/base excess(BE) is well anchored in clinicians’ practice. However, clinicians may not fully understand the concepts behind BD and the concerns regarding the validity of BD results provided by the hospital laboratory. These concerns are linked to the inconsistencies between the equations to calculate BD, and that these equations do not consider the aspects of acid–base physiology at birth. Additionally, the evidence-based supporting BD threshold in the literature to help physicians in making decisions is rather insufficient. These considerations support the need to review practice guidelines that use BD to guide decisions and bring to an end to clinicians to sail blindly in a thick fog.

Keywords:

• Acid–base status
• base excess
• hypoxic-ischemic encephalopathy
• neonatal metabolic acidosis
• umbilical artery cord gas

Acknowledgements

We would like to thank Francesca de Vries for her help in reviewing this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.