A case‐based review of a simplified quantitative approach to acid‐base analysis

Objective – To present a simplified quantitative approach to acid‐base analysis and to demonstrate its clinical utility. Data Sources – Original research articles and textbooks. Data Synthesis – A simplified quantitative approach to acid‐base analysis is presented, which is derived from the Fencl‐Stewart approach and calculates the magnitude of the effect on the standardized base excess (SBE) of 5 separate variables: (1) a free water effect (marked by sodium concentration), (2) an effect marked by the chloride concentration, (3) an albumin effect, (4) a lactate effect, and (5) a phosphate effect. Six clinical cases with acid‐base abnormalities are presented in which the quantitative approach provides information that is not apparent from the traditional approach. Conclusion – This simplified quantitative approach provides a comprehensive evaluation of complex acid‐base disorders, identifies individual processes and their relative influence on SBE, and aids in the development of an appropriate therapeutic plan.