Introduction to an alternate view of acid/base balance: The strong ion difference or stewart approach
The carbonic acid/bicarbonate system, as defined by the Henderson-Hasselbach (H-H) equation1, has traditionally formed the centrepiece of the presentation of acid/base physiology in nursing education. However, an alternative approach to describe acid/base physiology was proposed by Peter Stewart in...
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ftdeakinunifig:oai:figshare.com:article/20587455 2023-05-15T15:52:52+02:00 Introduction to an alternate view of acid/base balance: The strong ion difference or stewart approach M Boyle Ian Baldwin 2002-02-01T00:00:00Z http://hdl.handle.net/10536/DRO/DU:30172920 https://figshare.com/articles/journal_contribution/Introduction_to_an_alternate_view_of_acid_base_balance_The_strong_ion_difference_or_stewart_approach/20587455 unknown http://hdl.handle.net/10536/DRO/DU:30172920 https://figshare.com/articles/journal_contribution/Introduction_to_an_alternate_view_of_acid_base_balance_The_strong_ion_difference_or_stewart_approach/20587455 All Rights Reserved Uncategorized Untagged Text Journal contribution 2002 ftdeakinunifig 2022-11-17T18:08:58Z The carbonic acid/bicarbonate system, as defined by the Henderson-Hasselbach (H-H) equation1, has traditionally formed the centrepiece of the presentation of acid/base physiology in nursing education. However, an alternative approach to describe acid/base physiology was proposed by Peter Stewart in 19832. Stewart determined, using the physiochemical principles of dissociation equilibrium, electroneutrality and conservation of mass, that hydrogen ion concentration [H+] was dependent upon the difference between the concentrations of strong cations and strong anions in a solution (the strong ion difference or SID), concentration of weak acid anions, and the partial pressure of carbon dioxide in plasma. Therefore, a change in pH (the [H+] expressed as its negative log) indicates that there must be a change in one of these independent variables, and not simply explained by movement of hydrogen ions or bicarbonate into or out of the body fluids. An analysis of the complex acid/base derangements commonly seen in the critically ill can be achieved using this approach. The acid/base consequences of vomiting, gastric aspiration, diarrhoea, diuretic therapy, the infusion of large volumes of normal saline, the contribution of lactate, and the effects of methanol and ethylene glycol poisoning can all be more readily understood considering Stewart's explanation of acid/base balance. This paper outlines this alternative approach and provides some examples for the intensive care setting. © 2002 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd.). Other Non-Article Part of Journal/Newspaper Carbonic acid DRO - Deakin Research Online |
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Uncategorized Untagged M Boyle Ian Baldwin Introduction to an alternate view of acid/base balance: The strong ion difference or stewart approach |
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The carbonic acid/bicarbonate system, as defined by the Henderson-Hasselbach (H-H) equation1, has traditionally formed the centrepiece of the presentation of acid/base physiology in nursing education. However, an alternative approach to describe acid/base physiology was proposed by Peter Stewart in 19832. Stewart determined, using the physiochemical principles of dissociation equilibrium, electroneutrality and conservation of mass, that hydrogen ion concentration [H+] was dependent upon the difference between the concentrations of strong cations and strong anions in a solution (the strong ion difference or SID), concentration of weak acid anions, and the partial pressure of carbon dioxide in plasma. Therefore, a change in pH (the [H+] expressed as its negative log) indicates that there must be a change in one of these independent variables, and not simply explained by movement of hydrogen ions or bicarbonate into or out of the body fluids. An analysis of the complex acid/base derangements commonly seen in the critically ill can be achieved using this approach. The acid/base consequences of vomiting, gastric aspiration, diarrhoea, diuretic therapy, the infusion of large volumes of normal saline, the contribution of lactate, and the effects of methanol and ethylene glycol poisoning can all be more readily understood considering Stewart's explanation of acid/base balance. This paper outlines this alternative approach and provides some examples for the intensive care setting. © 2002 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd.). |
format |
Other Non-Article Part of Journal/Newspaper |
author |
M Boyle Ian Baldwin |
author_facet |
M Boyle Ian Baldwin |
author_sort |
M Boyle |
title |
Introduction to an alternate view of acid/base balance: The strong ion difference or stewart approach |
title_short |
Introduction to an alternate view of acid/base balance: The strong ion difference or stewart approach |
title_full |
Introduction to an alternate view of acid/base balance: The strong ion difference or stewart approach |
title_fullStr |
Introduction to an alternate view of acid/base balance: The strong ion difference or stewart approach |
title_full_unstemmed |
Introduction to an alternate view of acid/base balance: The strong ion difference or stewart approach |
title_sort |
introduction to an alternate view of acid/base balance: the strong ion difference or stewart approach |
publishDate |
2002 |
url |
http://hdl.handle.net/10536/DRO/DU:30172920 https://figshare.com/articles/journal_contribution/Introduction_to_an_alternate_view_of_acid_base_balance_The_strong_ion_difference_or_stewart_approach/20587455 |
genre |
Carbonic acid |
genre_facet |
Carbonic acid |
op_relation |
http://hdl.handle.net/10536/DRO/DU:30172920 https://figshare.com/articles/journal_contribution/Introduction_to_an_alternate_view_of_acid_base_balance_The_strong_ion_difference_or_stewart_approach/20587455 |
op_rights |
All Rights Reserved |
_version_ |
1766387975632977920 |