Published online Feb 4, 2015. doi: 10.5492/wjccm.v4.i1.62
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
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.