SIGGAARDANDERSEN AND THE GREAT TRANS-ATLANTIC ACID-BASE DEBATE

In the late 1950's, while working with Poul Astrup's equilibration method of blood gas analysis, Siggaard-Andersen introduced a new Parameter called base excess (BE) to quantify the non-respiratory acid-base imbalance. ''The Great-Transatlantic Acid-Base Debate'' arose when the ''Boston'' school, whose bicarbonate based analysis had been developed during pre-1950 Van Slyke days, (initially) argued that BE was not independent of Pco2 in vivo. Although Siggaard-Andersen and others then introduced a standard BE independent of Pco2, the Boston and Copenhagen schools are ''unreconciled''. While SBE is now used by most physicians, teaching and interpretation of acid-base chemistry remains confusing, '' Boston '' school laboratories refusing to report SBE, their students being asked to learn the 6 bicarbonate equations and rules, an old concept being reintroduced as ''strong ion difference'', or SID, and some wanting to discard pH in favor of nanomoles of H+, and end the era of ''Arrhenius, Severinghaus and Henderson-Hasselbalch''.