Evaluation of Acid-Base Disorders in Two Patients Using Stewart’s Approach

Disturbances of acid-base balance can result from serious cellular and general consequences. Monitoring of blood pH is clinically important to evaluate and understand the physiological condition of a critically ill patient. The traditional approach to acid-base equilibrium based on the Henderson –Hasselbalch equation focuses on changes in the concentration of bicarbonate (HCO 3 -), the partial pressure of carbon dioxide (pCO 2), the dissociation constant and the solubility of CO 2 . The Stewart's approach, however, based on the analysis of the complex components of physiologic fluid, such as sodium (Na +), potassium (K +), calcium (Ca 2+), magnesium (Mg 2+), chloride (Cl -), pCO 2 , lactate, phosphorus, and protein, provides better information and a more accurate conceptual view of acid-base mechanism. In this review, we evaluate two cases of acid-base disturbance, one after major surgery, and the other after liver transplantation, using the Stewart's approach, and compare it with the traditional approach.

Academic paper: Stewart's approach to acid-base disorders Evaluation of Acid-Base Disorders in Two Patients Using Stewart's Approach. Available from: https://www.researchgate.net/publication/268330951_Stewart's_approach_to_acid-base_disorders_Evaluation_of_Acid-Base_Disorders_in_Two_Patients_Using_Stewart's_Approach [accessed Apr 21, 2017].