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In reply

We read with interest the comments by Dr Lujan regarding our study examining the correlation between the serum bicarbonate and arterial base deficit.¹ He provides an excellent example of the confusion around the terminology base deficit and base excess. We would disagree with using both terms and referring to a positive value as a base excess and a negative value as a base deficit. We used the single term base deficit, with a positive value indicating a deficit or metabolic acidosis and a negative value indicating an excess or metabolic alkalosis. We believe this is a simpler and more clinically relevant approach, and is consistent with the current literature on this topic.

Dr Lujan then states that the relationship between the bicarbonate and base deficit is only valid if the pH is held constant, and thus our conclusions may not be valid in patients who have not compensated . . . [Full Text of this Article]

AUTHOR INFORMATION
Matthew J. Martin, MD

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