apfcbAPFCB eNewscoAPFCB News Volume 3, Issue 2MultidisciplinaryEnglishJul-Dec, 2024NNY2024091ArticlesThe ‘Great Trans-Atlantic Acid-Base Debate: Current Status in the age of Artificial IntelligenceEnglishY6370Prof AamirIjaz1EnglishN10.62772/APFCB-News.2024.2.1Blood gas analysis (BGA) is one of the most common investigations carried out in critically ill patients. All the results mentioned in the print-out from the BGA equipment are not measured directly but some are calculated using formulae devised by great scientists like Henderson and Hasselbalch. Similarly, in 1950s, interpretation rules were suggested by a group of scientists from Boston Massachusetts US. These rules were based on two BGA parameters i.e. partial pressure of arterial Carbon Dioxide (PaCO2) and concentration of bicarbonate [HCO3].These rules were, however, criticized on the plea that some ‘extra luggage’ has been added on a cognitively over-loaded plethora of symbols appearing ‘Latin’ to a novice. In Copenhagen (Denmark), on other side of the Atlantic Ocean, some parameters were proposed for quantitative assessment of metabolic acid-base abnormalities. These include Standard Bicarbonate (stHCO3), Base Excess (BE) and Standard Base (SBE). These parameters were severely criticized by Boston Group mainly on the ground that these parameters are derived ‘in vitro’ and not valid for ‘in vivo’. Such debates are quite desirable and must continue by the new generations of scientists to find a solution based on Artificial Intelligence, so that the machines should not only give the data (plethora of symbols) but also exact diagnosis of acid-base disorders, stoichiometric analysis and the amount of acid or base required to be given to the patient.EnglishMetabolic Acidosis, Base Excess, Standard Bicarbonate, Standard Base Excesshttps://apfcb.org/APFCB_News/abstract?id=14References16191. T. J. Morgan. Standard Base Excess. In: Australasian Anaesthesia [Internet]. ANZCA; 2013. p. 100. Cited on 15th July 2024; Available from: https://airr.anzca.edu.au/anzcajspui/bitstream/11055/950/1/Australasian Anaesthesia 2003 2. Sadiq S, Ijaz A, Hussain M. Establishing correlation of pH with various physiochemical and traditional parameters of acid base balance: a cross-sectional study. Khyber Medical University Journal. 2022; 14(2):104and;ndash;9. 3. Anzca. Australasian anaesthesia 2013. 2013; 1and;ndash;119. Available from: papers2://publication/uuid/5B9A7B12-9DDF-46CE-964F-94A7611F76FE 4. Shwartz WB, Relman AS. A critique of the parameters used in the evaluation of acid-base disorders. N Engl J Med.1963; 328(8):268:1382-1388. 5. Todi S. Arterial Blood Gas Analysis: A New Look at the Old Formula. Indian Journal of Critical Care Medicine. 2023; 27(10):699and;ndash;700. 6. Sood P, Paul G, Puri S. Interpretation of arterial blood gas. Indian Journal of Critical Care Medicine. 2010; 14(2):57and;ndash;64. 7. Oosthuizen NM, Head A, Academic T. Approach to acid-base disorders and;ndash; a clinical chemistry perspective Systematic approach. 2012; 30(7):1and;ndash;8. 8. Acid Base Disorders. In: Ijaz A, editor. Lahore Chemical Pathology for the Beginners 1st Edition Azeem Sons; 2018. p. 94and;ndash;8. 9. Jand;oslash;rgensen K, Astrup P. Standard bicarbonate, its clinical significance, and a new method for its determination. Scand J Clin Lab Invest. 1957; 9(2):122and;ndash;32. 10. O.Siggaard-Andersen 1994-05-31 (revised 2004-01-25). Definition of base excess and concentration of titratable hydrogen ion: [cited 2024 Jul 17]. Anthology on Base Excess. Available from: http://www.siggaard-andersen.dk/OsaAnthologyOnBE.htm 11. Severinghaus JW. Siggaard-andersen and the and;ldquo;great trans-Atlantic acid-base debate.and;rdquo; Scand J Clin Lab Invest. 1993; 53(s214):99and;ndash;104. 12. Schlichtig R, Grogono AW, Severinghaus JW. Human PaCO2 and standard base excess compensation for acid-base imbalance. Crit Care Med. 1998; 26(7):1173and;ndash;9. 13. Samuel R. Application of Boston Compensation Rules in the Development of a Stepwise Approach for Novel Diagnostic Arterial Blood Gas Interpretation Method. Indian Journal of Critical Care Medicine. 2023; 27(10):717and;ndash;23.