For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
73
views
48
references
 Top references
cited by
10
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      171
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: not found

      Science review: Quantitative acid–base physiology using the Stewart model

      review-article
      Author(s): 1 ,
      Publication date (Electronic):
      Journal: Critical Care
      Publisher: BioMed Central
      Keywords: acid–base, base excess, Stewart model

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          There has been renewed interest in quantifying acid–base disorders in the intensive care unit. One of the methods that has become increasingly used to calculate acid–base balance is the Stewart model. This model is briefly discussed in terms of its origin, its relationship to other methods such as the base excess approach, and the information it provides for the assessment and treatment of acid–base disorders in critically ill patients.

          Related collections

          Most cited references48

          • Record: found
          • Abstract: found
          • Article: not found

          Human albumin administration in critically ill patients: systematic review of randomised controlled trials.

          (1998)
          To quantify effect on mortality of administering human albumin or plasma protein fraction during management of critically ill patients. Systematic review of randomised controlled trials comparing administration of albumin or plasma protein fraction with no administration or with administration of crystalloid solution in critically ill patients with hypovolaemia, burns, or hypoalbuminaemia. 30 randomised controlled trials including 1419 randomised patients. Mortality from all causes at end of follow up for each trial. For each patient category the risk of death in the albumin treated group was higher than in the comparison group. For hypovolaemia the relative risk of death after albumin administration was 1.46 (95% confidence interval 0.97 to 2.22), for burns the relative risk was 2.40 (1.11 to 5.19), and for hypoalbuminaemia it was 1.69 (1.07 to 2.67). Pooled relative risk of death with albumin administration was 1.68 (1.26 to 2.23). Pooled difference in the risk of death with albumin was 6% (95% confidence interval 3% to 9%) with a fixed effects model. These data suggest that for every 17 critically ill patients treated with albumin there is one additional death. There is no evidence that albumin administration reduces mortality in critically ill patients with hypovolaemia, burns, or hypoalbuminaemia and a strong suggestion that it may increase mortality. These data suggest that use of human albumin in critically ill patients should be urgently reviewed and that it should not be used outside the context of rigorously conducted, randomised controlled trials.
          Article 0 comments Cited 104 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Determinants of blood pH in health and disease

            John A. Kellum (2000)
            An advanced understanding of acid–base physiology is as central to the practice of critical care medicine, as are an understanding of cardiac and pulmonary physiology. Intensivists spend much of their time managing problems related to fluids, electrolytes, and blood pH. Recent advances in the understanding of acid–base physiology have occurred as the result of the application of basic physical-chemical principles of aqueous solutions to blood plasma. This analysis has revealed three independent variables that regulate pH in blood plasma. These variables are carbon dioxide, relative electrolyte concentrations, and total weak acid concentrations. All changes in blood pH, in health and in disease, occur through changes in these three variables. Clinical implications for these findings are also discussed.
            Article 0 comments Cited 75 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The role of serum proteins in acid-base equilibria.

              James J Figge, Henrik Rossing, V FENCL (1991)
              Serum proteins act as weak acids and participate in acid-base balance. Their effects are imprecisely quantified; in particular, the roles of albumin and globulins need reevaluation. We approached the problem in three steps. First, in artificial solutions resembling serum but with human serum albumin as the only protein moiety, we varied the strong ion difference (SID), partial pressure of carbon dioxide (Pco2) and the concentration of albumin [( Alb]) and fixed the concentration of inorganic phosphate [( Pi]). We measured pH and derived the charges on albumin. Second, extending the work of Stewart (Stewart PA. How to understand acid-base. A quantitative acid-base primer for biology and medicine. New York: Elsevier, 1981:1-286), we developed a mathematical model that solves for pH and for the charges on albumin as functions of SID, Pco2, [Pi], and [Alb]. The calculated values fit the observed values well; that is, the model describes well the behavior of these solutions over a wide range of simulated complex acid-base disturbances. Finally, in human serum samples containing both albumin and globulins, we varied SID, Pco2, and total protein concentration [( TP]); we fixed [Pi] and then measured pH and derived the charges on proteins as above. When we applied to these data the computer model developed for albumin alone, the calculated pH and derived charges on albumin values agreed well with the observed pH and derived charges on proteins. We conclude first that human serum globulins play a negligible role in acid-base equilibria, and second, that in normal human serum at pH 7.40 with [TP] = 7 and [Alb] = 4.3 gm/dl, the charges attributed to proteins are approximately 12 mEq/L; this is substantially less than the value of approximately 17 mEq/L given by many contemporary texts, based on work of van Slyke et al. (van Slyke DD, Hastings AB, Hiller A, Sendroy J Jr. Studies of gas and electrolyte equilibria in blood. XIV. Amounts of alkali bound by serum albumin and globulin. J Biol Chem 1928;79:769-80). These findings should be considered when evaluating acid-base balance in patients with abnormal serum albumin concentration, for example, when interpreting values of the anion gap.
              Article 0 comments Cited 43 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Crit Care
                Title: Critical Care
                Publisher: BioMed Central (London )
                ISSN (Print): 1364-8535
                ISSN (Electronic): 1466-609X
                Publication date (Print): 2004
                Publication date (Electronic): 2 July 2004
                Volume: 8
                Issue: 6
                Pages: 448-452
                Affiliations
                [1 ]Attending Physician, Radiology Associates, PA, Little Rock, Arkansas, USA
                Article
                Publisher ID: cc2910
                DOI: 10.1186/cc2910
                PMC ID: 1065045
                PubMed ID: 15566615
                SO-VID: 7560bc84-58ff-41b0-bad1-1d4a6f6e4f29
                Copyright © Copyright © 2004 BioMed Central Ltd
                History
                Categories
                Subject: Review

                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: base excess,stewart model,acid–base
                Data availability:
                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: base excess, stewart model, acid–base

                Comments

                Comment on this article

                scite_

                Similar content171

                See all similar

                Cited by10

                See all cited by

                Most referenced authors275

                See all reference authors