Severinghaus J W
Department of Anesthesia, University of California, San Francisco 94143-0542.
Scand J Clin Lab Invest Suppl. 1993;214:99-104.
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".
20世纪50年代末，西格gaard - 安德森在运用保罗·阿斯屠普的血气分析平衡方法时，引入了一个名为碱剩余（BE）的新参数，用于量化非呼吸性酸碱失衡。当“波士顿”学派（其基于碳酸氢盐的分析方法是在20世纪50年代前范斯莱克时代发展起来的）（最初）认为体内碱剩余并非独立于二氧化碳分压（PCO2）时，引发了“跨大西洋酸碱大辩论”。尽管西格gaard - 安德森等人随后引入了独立于PCO2的标准碱剩余，但波士顿学派和哥本哈根学派仍“未达成和解”。虽然目前大多数医生使用标准碱剩余，但酸碱化学的教学和解读仍然令人困惑，“波士顿”学派的实验室拒绝报告标准碱剩余，他们要求学生学习六个碳酸氢盐方程和规则，一个旧概念被重新引入称为“强离子差”或SID，还有一些人希望舍弃pH值而采用纳摩尔氢离子，并终结“阿伦尼乌斯、塞弗林豪斯和亨德森 - 哈塞尔巴尔赫”时代。
