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

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.

以碱缺失（base deficit, BD）/碱过剩（base excess, BE）评估新生儿出生时的健康状态，已广泛应用于临床医师的日常诊疗工作中。然而，临床医师往往未能充分理解BD的核心概念，同时也对医院检验科出具的BD检测结果的有效性存在疑虑。此类疑虑源于两方面：一是BD的计算公式尚未统一，存在不一致性；二是现有计算公式未纳入新生儿出生时的酸碱生理特征。此外，现有文献中可供临床医师决策参考的循证BD阈值标准仍较为匮乏。上述问题均表明，亟需对以BD为决策依据的临床实践指南进行修订，以彻底终结临床医师在诊疗中如坠迷雾、盲目决策的现状。