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February 28, 2026British Journal of AnaesthesiaOpen Access

Improving interpretation of metabolic acid–base disorders by correcting pH-dependent bias in base excess partitioning

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Authors

MKMartin KrbecCharles UniversityMVMartin VancuraCharles UniversityPWP WaldaufCharles University

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Implication

Analysis reveals improved metabolic acid-base disorder interpretation in ICU patients by adjusting pH bias.

Key Points

  • The study aims to assess the impact of pH correction on the accuracy of base excess partitioning in diagnosing metabolic acid-base disorders.
  • Developed a novel pH-corrected method for estimating base excess using adjusted strong ion difference.
  • Analyzed data from 5976 ICU patients using Bland-Altman plots to assess agreement between methods.
  • Used linear regression to evaluate the independent effect of pH on the conventional base excess calculations.
  • Conventional method showed wide limits of agreement and strong pH confounding effects.
  • The pH-corrected algorithm improved agreement with strong ion gap significantly.
  • Reduction of confounding effect from pH was observed, indicating better reliability in assessment.

Cite This Study

Krbec et al. (2026) studied this question.

synapsesocial.com/papers/69a286b80a974eb0d3c01e81https://doi.org/10.1016/j.bja.2026.02.001
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