SIGGAARDANDERSEN AND THE GREAT TRANS-ATLANTIC ACID-BASE DEBATE

In the late 1950's, while working with Poul Astrup's equilibration met hod of blood gas analysis, Siggaard-Andersen introduced a new Paramete r called base excess (BE) to quantify the non-respiratory acid-base im balance. ''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 ind ependent of Pco2 in vivo. Although Siggaard-Andersen and others then i ntroduced a standard BE independent of Pco2, the Boston and Copenhagen schools are ''unreconciled''. While SBE is now used by most physician s, teaching and interpretation of acid-base chemistry remains confusin g, '' Boston '' school laboratories refusing to report SBE, their stud ents being asked to learn the 6 bicarbonate equations and rules, an ol d concept being reintroduced as ''strong ion difference'', or SID, and some wanting to discard pH in favor of nanomoles of H+, and end the e ra of ''Arrhenius, Severinghaus and Henderson-Hasselbalch''.