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Title: Bench-to-bedside review: a brief history of clinical acid-base.
Austin Authors: Story, David A 
Affiliation: The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 30-Apr-2004
Publication information: Critical Care 2004; 8(4): 253-8
Abstract: The history of assessing the acid-base equilibrium and associated disorders is intertwined with the evolution of the definition of an acid. In the 1950s clinical chemists combined the Henderson-Hasselbalch equation and the Bronsted-Lowry definition of an acid to produce the current bicarbonate ion-centred approach to metabolic acid-base disorders. Stewart repackaged pre-1950 ideas of acid-base in the late 1970s, including the Van Slyke definition of an acid. Stewart also used laws of physical chemistry to produce a new acid-base approach. This approach, using the strong ion difference (particularly the sodium chloride difference) and the concentration of weak acids (particularly albumin), pushes bicarbonate into a minor role as an acid-base indicator rather than as an important mechanism. The Stewart approach may offer new insights into acid-base disorders and therapies.
Gov't Doc #: 15312207
DOI: 10.1186/cc2861
Type: Journal Article
Subjects: Acid-Base Equilibrium
Acid-Base Imbalance.diagnosis.history.metabolism
Blood Gas Analysis
History, 20th Century
Ion Exchange
Point-of-Care Systems
Appears in Collections:Journal articles

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