WordNet

any of various water-soluble compounds capable of turning litmus blue and reacting with an acid to form a salt and water; "bases include oxides and hydroxides of metals and ammonia" (同)alkali
(numeration system) the positive integer that is equivalent to one in the next higher counting place; "10 is the radix of the decimal system" (同)radix
the bottom side of a geometric figure from which the altitude can be constructed; "the base of the triangle"
situate as a center of operations; "we will base this project in the new lab"
a place that the runner must touch before scoring; "he scrambled to get back to the bag" (同)bag
installation from which a military force initiates operations; "the attack wiped out our forward bases" (同)base of operations
a support or foundation; "the base of the lamp" (同)pedestal, stand
(electronics) the part of a transistor that separates the emitter from the collector
a flat bottom on which something is intended to sit; "a tub should sit on its own base"
the principal ingredient of a mixture; "glycerinated gelatin is used as a base for many ointments"; "he told the painter that he wanted a yellow base with just a hint of green"; "everything she cooked seemed to have rice as the base"
the place where you are stationed and from which missions start and end (同)home
(anatomy) the part of an organ nearest its point of attachment; "the base of the skull"
the bottom or lowest part; "the base of the mountain"
illegitimate (同)baseborn
of low birth or station (`base is archaic in this sense); "baseborn wretches with dirty faces"; "of humble (or lowly) birth" (同)baseborn, humble, lowly
not adhering to ethical or moral principles; "base and unpatriotic motives"; "a base, degrading way of life"; "cheating is dishonorable"; "they considered colonialism immoral"; "unethical practices in handling public funds" (同)immoral
having or showing an ignoble lack of honor or morality; "that liberal obedience without which your army would be a base rabble"- Edmund Burke; "taking a mean advantage"; "chokd with ambition of the meaner sort"- Shakespeare; "something essentially vulgar and meanspirited in politics" (同)mean, meanspirited
(used of metals) consisting of or alloyed with inferior metal; "base coins of aluminum"; "a base metal"
debased; not genuine; "an attempt to eliminate the base coinage"
more than is needed, desired, or required; "trying to lose excess weight"; "found some extra change lying on the dresser"; "yet another book on heraldry might be thought redundant"; "skills made redundant by technological advance"; "sleeping in the spare room"; "supernumerary ornamentation"; "it was supererogatory of her to gloat"; "delete superfluous (or unnecessary) words"; "extra ribs as well as other supernumerary internal parts"; "surplus cheese distributed to the needy" (同)extra, redundant, spare, supererogatory, superfluous, supernumerary, surplus
immoderation as a consequence of going beyond sufficient or permitted limits (同)excessiveness, inordinateness
a quantity much larger than is needed (同)surplus, surplusage, nimiety
having a base; "firmly based ice"
having a base of operations (often used as a combining form); "a locally based business"; "an Atlanta-based company"; "carrier-based planes"

PrepTutorEJDIC

《文》(人や人の行動・孝えが)『卑しい』,下劣な / (金属が)質の劣った;(貨幣が)粗悪な
『基礎』,根拠 / 『基部』,基底,土台 / 『根拠地』,基地 / (野球の)塁,ベース / 主成分;塩基(酸と反応シテ塩(官)を生じる化合物) / (数学で図形の)底;底辺;基線 / (…に)…‘の'『基礎をおく』《+『名』+『on』(『upon』)+『名』》
〈U〉《時にan~》(…の…に対する)超過《+『of』+『名』+『over』+『名』》 / 〈U〉(…の)『不節制』《+『at』+『名,』+『in』 do『ing』》;《複数形で》度を超えた行為,不行跡;暴飲,暴食 / 超過の,余分の
basisの複数形

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/11/18 18:07:14」(JST)

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In human physiology, base excess and base deficit refer to an excess or deficit, respectively, in the amount of base present in the blood. The value is usually reported as a concentration in units of mEq/L, with positive numbers indicating an excess of base and negative a deficit. A typical reference range for base excess is −2 to +2 mEq/L.^[1]

Comparison of the base excess with the reference range assists in determining whether an acid/base disturbance is caused by a respiratory, metabolic, or mixed metabolic/respiratory problem. While carbon dioxide 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 titrating back to a standardized blood pH of 7.40.

The predominant base contributing to base excess is bicarbonate. 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.

Definition[edit]

Pathophysiology sample values
BMP/ELECTROLYTES:
Na⁺ = 140	Cl⁻ = 100	BUN = 20	/
			Glu = 150
K⁺ = 4	CO₂ = 22	PCr = 1.0	\
ARTERIAL BLOOD GAS:
HCO₃^- = 24	p_aCO₂ = 40	p_aO₂ = 95	pH = 7.40
ALVEOLAR GAS:
	p_ACO₂ = 36	p_AO₂ = 105	A-a g = 10
OTHER:
Ca = 9.5	Mg²⁺ = 2.0	PO₄ = 1
CK = 55	BE = −0.36	AG = 16
SERUM OSMOLARITY/RENAL:
PMO = 300	PCO = 295	POG = 5	BUN:Cr = 20
URINALYSIS:
UNa⁺ = 80	UCl⁻ = 100	UAG = 5	FENa = 0.95
UK⁺ = 25	USG = 1.01	UCr = 60	UO = 800
PROTEIN/GI/LIVER FUNCTION TESTS:
LDH = 100	TP = 7.6	AST = 25	TBIL = 0.7
ALP = 71	Alb = 4.0	ALT = 40	BC = 0.5
		AST/ALT = 0.6	BU = 0.2
AF alb = 3.0	SAAG = 1.0		SOG = 60
CSF:
CSF alb = 30	CSF glu = 60	CSF/S alb = 7.5	CSF/S glu = 0.4

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 pCO₂ of 40 mmHg (5.3 kPa).^[2] A base deficit (i.e., a negative base excess) can be correspondingly defined in terms of the amount of strong base that must be added.

A further distinction can be made between actual and standard base excess: actual base excess is that present in the blood, while standard base excess is the value when the hemoglobin is at 5 g/dl. The latter gives a better view of the base excess of the entire extracellular fluid.^[3]

The term and concept of base excess were first introduced by Poul Astrup and Ole Siggaard-Andersen in 1958.

Estimation[edit]

Base excess can be estimated from the serum bicarbonate concentration ([HCO₃^-]) and pH by the equation:^[4]

with units of mEq/L. The same can be alternatively expressed as

Calculations are based on the Henderson-Hasselbalch equation:

Ultimately the end result is:

Interpretation[edit]

Base excess beyond the reference range indicates

metabolic alkalosis if too high (more than +2 mEq/L)
metabolic acidosis if too low (less than −2 mEq/L)

Blood pH is determined by both a metabolic component, measured by base excess, and a respiratory component, measured by pCO₂ (partial pressure of carbon dioxide). Often a disturbance in one triggers a partial compensation in the other. A secondary (compensatory) process can be readily identified because it opposes the observed deviation in blood pH.

For example, inadequate ventilation, a respiratory problem, causes a buildup of CO₂, 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. acidosis. In summary, the kidneys partially compensate for respiratory acidosis by raising blood bicarbonate.

A high base excess, thus metabolic alkalosis, usually involves an excess of bicarbonate. It can be caused by

Compensation for primary respiratory acidosis
Excessive loss of HCl in gastric juice by vomiting
Renal overproduction of bicarbonate, in either contraction alkalosis or Cushing's disease

A base deficit (a below-normal base excess), thus metabolic acidosis, usually involves either excretion of bicarbonate or neutralization of bicarbonate by excess organic acids. Common causes include

Compensation for primary respiratory alkalosis
Diabetic ketoacidosis, in which high levels of acidic ketone bodies are produced
Lactic acidosis, due to anaerobic metabolism during heavy exercise or hypoxia
Chronic renal failure, preventing excretion of acid and resorption and production of bicarbonate
Diarrhea, in which large amounts of bicarbonate are excreted
Ingestion of poisons such as methanol, ethylene glycol, or excessive aspirin

The serum anion gap is useful for determining whether a base deficit is caused by addition of acid or loss of bicarbonate.

Base deficit with elevated anion gap indicates addition of acid (e.g., ketoacidosis).
Base deficit with normal anion gap indicates loss of bicarbonate (e.g., diarrhea). The anion gap is maintained because bicarbonate is exchanged for chloride during excretion.

See[edit]

Acid-base homeostasis
Metabolic acidosis / Metabolic alkalosis
Arterial blood gas

References[edit]

^ Frances Talaska Fischbach; Marshall Barnett Dunning (2008), A Manual of Laboratory and Diagnostic Tests (8th ed.), p. 973, ISBN 978-0-7817-7194-8.
^ Jonathan D. Kibble; Colby R. Halsey (2009), Medical Physiology: The Big Picture, p. 249, ISBN 978-0-07-164302-3.
^ Acid-Base Tutorial — Terminology
^ Medical Calculators > Calculated Bicarbonate & Base Excess Steven Pon, MD, Weill Medical College of Cornell University

External links[edit]

acid-base.com
Anthology on Base Excess (O.Siggaard-Andersen)
Base+excess at eMedicine Dictionary
-321912807 at GPnotebook
Emedicine: Lactic Acidosis

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 単純性および混合性酸塩基障害 simple and mixed acid base disorders
2. 動脈血液ガス arterial blood gases
3. 胎児の酸塩基の生理学 fetal acid base physiology
4. 臍帯血酸塩基分析 umbilical cord blood acid base analysis
5. 静脈血ガスおよび動脈血液ガスの代替 venous blood gases and other alternatives to arterial blood gases

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du Bois de Maquillé L, Renaudin L, Goutelard F, Jardy A, Vial J, Thiébaut D.SourceLaboratoire d'Analyses en Soutien aux Exploitants du CEA de SACLAY, DEN/DANS/DPC/SEARS/LASE, Bât 459, 91191 Gif-sur-Yvette, France. Electronic address: laurence.de-maquille@cea.fr.
Journal of chromatography. A.J Chromatogr A.2013 Feb 8;1276:20-5. doi: 10.1016/j.chroma.2012.10.055. Epub 2012 Dec 3.
EDTA is a chelating agent that has been used in decontamination processes. Its quantification is required for nuclear waste management because it affects the mobility of radionuclides and metals in environment and, thus, can harm the safety of the storage. Ion-pair chromatography coupled with electr
PMID 23312862

Reactions of acids with naphthyridine-functionalized ferrocenes: protonation and metal extrusion.

Sadhukhan N, Sarkar M, Ghatak T, Rahaman SM, Barbour LJ, Bera JK.SourceDepartment of Chemistry, Indian Institute of Technology Kanpur , Kanpur 208016, India.
Inorganic chemistry.Inorg Chem.2013 Feb 4;52(3):1432-42. doi: 10.1021/ic302155e. Epub 2013 Jan 24.
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PMID 23347083

Japanese Journal

Injection-Current-Induced Blue-Shift Laser Diode: Concept of Excess Carrier Conservation

Murasawa Kengo,Hidaka Takehiko,Sato Koki
Jpn J Appl Phys 50(4), 042101-042101-14, 2011-04-25
… We report the blue-shift characteristics of continuous-wave oscillation wavelength induced by the current injection of a GaAs-base laser diode. … The cause of the blue shift in the laser diode reported here is the effect of the conserved excess-carrier-induced refractive-index reduction, which is superior to the temperature-rising effect. …
NAID 150000055474

読めばわかる!酸塩基平衡(6)塩基余剰(base excess:BE)

大塚将秀
看護技術 57(7), 634-636, 2011-06
NAID 40018847552

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リンク元	「血液ガス分析」「塩基過剰」「BE」「過剰塩基」
拡張検索	「standard base excess」
関連記事	「base」「excess」

「血液ガス分析」

Base excess
	Diagnostics
LOINC	11555-0

　　[★]

英: blood gas analysis BGA
同: 動脈血ガス分析、動脈血ガス分析法 arterial blood gas analysis
関: 動脈血ガス、血液ガス

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血液ガス分析 : 約 27,700 件
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pH　　　： 7.35-7.45
paCO2　：35-45 mmHg　　　　　　　　　　　　　　：換気状態
paO2　　：80-95 mmHg (100 - age/4 mmHg)　　：酸素化能
HCO₃^-　：24±2

BE(base excess)：0±2 mEq/L

血液ガスの読み方

内科レジデントの鉄則第2版 p.223

1. 各項目に目を通す
2. pH
3. HCO3- 優位か？　PCO2 優位か？
4. アニオンギャップの計算

AG = Na - Cl - HCO3- = 12±2

ΔAG = AG - 12

補正[HCO3-] = 実測[HCO3-] + ΔAG

5. 代償性変化

	代償性変化の範囲	代償の限界
代謝性アシドーシス	ΔPCO2 = 1.2 x Δ[HCO3-] ± 5	PCO2 ≧ 15 torr
代謝性アルカローシス	ΔPCO2 = 0.8 x Δ[HCO3-] ± 5	PCO2 ≦ 60 torr
呼吸性アシドーシス	Δ[HCO3-] = 0.4 x ΔPCO2 ± 3 (慢性期)	[HCO3-] ≦ 42 mEq/l
呼吸性アルカローシス	Δ[HCO3-] = 0.4 x ΔPCO2 ± 3 (慢性期)	[HCO3-] ≧ 12 mEq/l