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Revista Mexicana de Anestesiología

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ISSN 0484-7903 (Print)
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2006, Number 4

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Rev Mex Anest 2006; 29 (4)

Acid-basic theory of Stewart, a new paradigm in critical medicine

Häubi SC, Moreno-Santillán A, de León-Ponce MD, Briones-Vega CG, Meneses-Calderón J, Orenday-Aréchiga ME, Torres-Pérez J, Briones-Garduño JC
Full text How to cite this article

Language: Spanish
References: 8
Page: 240-244
PDF size: 93.77 Kb.


Key words:

Acid-base balance, Stewart moder, Henderson-Hasselbalch model.

ABSTRACT

Human life is only possible within a narrow range of pH. Consequently, the body has different and complex mechanisms to maintain this balance. In normal circumstances, metabolic processes yield a number of acid by-products, reflecting a natural trend in pH towards acidity. However, blood pH is kept within physiological range because concentrations of hydrogen ions in both the extra- and intracellular compartments are closely controlled by the body, since very slight changes may lead to cell dysfunction. In order to maintain pH within normal ranges and avoid cell damage, hydrogen ions move across the intra and extracellular compartments. Acid-base disturbances are controlled by different buffer systems, described by Henderson and Hasselbalch using bicarbonate and carbon dioxide as independent variables. The acid-base model described by Stewart proposes that ion concentration is determined by the of laws chemistry acting upon independent variables, such as strong ion difference, carbon dioxide partial pressure, and weak anions. This paper describes important features of both methods, in order to set the basis for future research in this field.


REFERENCES

  1. Equilibrio ácido-básico. En: Herman Villarreal. Riñón y Electrolítos. México: Librería de Medicina; 1979:77-91.

  2. La teoría de Stewart. En: Häubi SC. Teoría ácido-básico de Stewart: Aplicaciones prácticas de una nueva teoría de la regulación del pH en los sistemas biológicos. México: Editorial Cigome S.A. de C.V.; 2004:35-67.

  3. Sirker AA, Rhodes A, Grounds RM, Bennett ED. Acid-base physiology: the “traditional” and the “modern” approaches. Anaesthesia 2002;57:348-356.

  4. Carreira F, Anderson RJ. Assessing metabolic acidosis in the intensive care unit: Does the method make a difference? Crit Care Med 2004;32:2131-2132.

  5. Stewart PA. Moderns quantitative acid-base chemistry. Can J Physiol Pharmacol 1983;61:1441-1461.

  6. Corey HE. Stewart and beyond: New models of acid-base balance. Kidney International 2003;64:777-787.

  7. Story DA, Morimatsu H, Bellomo R. Strong ions, weak acids and base excess: a simplified Fencl-Stewart approach to clinical acid-base disorders. British Journal of Anaesthesia 2004;92: 54-60.

  8. Fisiología y fisiopatología del equilibrio ácido-base. En: Díaz de León PM, Briones GJC, Vázquez AFG. Medicina Aguda. México Editorial Prado; 2006:111-136.




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C?MO CITAR (Vancouver)

Rev Mex Anest. 2006;29