©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Feb 4, 2015; 4(1): 62-70
Published online Feb 4, 2015. doi: 10.5492/wjccm.v4.i1.62
Published online Feb 4, 2015. doi: 10.5492/wjccm.v4.i1.62
Has Stewart approach improved our ability to diagnose acid-base disorders in critically ill patients?
Fabio D Masevicius, Arnaldo Dubin, Servicio de Terapia Intensiva, Sanatorio Otamendi y Miroli, Buenos Aires C1115AAB, Argentina
Arnaldo Dubin, Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 1900 La Plata, Argentina
Author contributions: Both authors contributed to this work.
Conflict-of-interest: The authors have no conflict of interest to disclose.
Correspondence to: Arnaldo Dubin, MD, PhD, Servicio de Terapia Intensiva, Sanatorio Otamendi y Miroli, Azcuénaga 870, C1115AAB Ciudad Autónoma de Buenos Aires, Argentina. arnaldodubin@gmail.com
Telephone: +54-91-150102431
Received: September 25, 2014
Peer-review started: September 28, 2014
First decision: December 17, 2014
Revised: December 29, 2014
Accepted: January 15, 2015
Article in press: Janurary 19, 2015
Published online: February 4, 2015
Processing time: 138 Days and 19.4 Hours
Peer-review started: September 28, 2014
First decision: December 17, 2014
Revised: December 29, 2014
Accepted: January 15, 2015
Article in press: Janurary 19, 2015
Published online: February 4, 2015
Processing time: 138 Days and 19.4 Hours
Core Tip
Core tip: In this article, we comprehensively reviewed the evidence that has been used to argue for the superiority of the Stewart approach over the traditional method for the analysis of acid-base metabolism in critically ill patients. The basic principles of the Stewart approach have severe weaknesses. In addition, the contribution of this method to the understanding of mechanisms is minor; furthermore, from a clinical standpoint, the Stewart approach has no advantage for diagnostic or prognostic purposes compared to the analysis based on bicarbonate, base excess, and albumin-corrected anion gap.