Acid-base chemistry of plasma: consolidation of the traditional and modern approaches from a mathematical and clinical perspective
2011
Abstract
Debate still exists as to whether the Stewart (modern) or traditional model of acid-base chemistry is best in assessing the acid-base status of critically ill patients. Recent studies have compared various parameters from the modern and traditional approaches, assessing the clinical usefulness of parameters such as base excess, anion gap, corrected anion gap, strong ion difference and strong ion gap.
To compare the clinical usefulness of these parameters, and hence the different approaches, requires a clear understanding of their meaning; a task only possible through understanding the mathematical basis of the approaches. The objective of this paper is to provide this understanding, limiting the mathematics to a necessary minimum.