Copyright ©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
Has Stewart approach improved our ability to diagnose acid-base disorders in critically ill patients?
Fabio D Masevicius, Arnaldo Dubin
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.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Arnaldo Dubin, MD, PhD, Servicio de Terapia Intensiva, Sanatorio Otamendi y Miroli, Azcuénaga 870, C1115AAB Ciudad Autónoma de Buenos Aires, Argentina.
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
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.