ArticleThe Clinical biochemist. Reviews2009
The Stewart approach--one clinician's perspective.
Article in The Clinical biochemist. Reviews, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Management of regional citrate anticoagulation for continuous renal replacement therapy: guideline recommendations from Chinese emergency medical doctor consensus.Military Medical Research · 2023Guideline
- Balanced crystalloid solutions versus 0.9% saline for treating acute diarrhoea and severe dehydration in children.The Cochrane database of systematic reviews · 2023Pooled it
- Terms, Definitions, Nomenclature, and Routes of Fluid Administration.Frontiers in veterinary science · 2020Pooled it
- Acid/base alterations during major abdominal surgery: 6% hydroxyethyl starch infusion versus 5% albumin.Korean journal of anesthesiology · 2018Trial
- Changes in acid-base and ion balance during exercise in normoxia and normobaric hypoxia.European journal of applied physiology · 2017Trial
- Confined spaces in space: Cerebral implications of chronic elevations of inspired carbon dioxide and implications for long-duration space travel.Experimental physiology · 2026Review
- When our treatment is complicated: an overview of drug-induced acid-base disorders: part 1-acidosis.Pediatric nephrology (Berlin, Germany) · 2026Review
- Effective buffers in intravenous solutions: reconciling the acid-base effects of organic anions.Critical care (London, England) · 2026Article
- Fluid-induced acid-base variations in postoperative critically ill patients: physiological determinants and renal response.Frontiers in medicine · 2026Article
- D- and L-lactate dehydrogenase reactions increase pH to lactate production and decrease pH to pyruvate production.Frontiers in molecular biosciences · 2026Article
- Article
- Quantifying pH-induced changes in plasma strong ion difference during experimental acidosis: clinical implications for base excess interpretation.Journal of applied physiology (Bethesda, Md. : 1985) · 2024Article
- A Comparison Between Saline and Balanced Solutions in Kidney Transplants: A Randomized Clinical Trial.Cureus · 2023Article
- Arterial Blood Gas Analysis: A New Look at the Old Formula.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Chloride and Potassium Assessment Is a Helpful Tool for Differential Diagnosis of Thiazide-Associated Hyponatremia.The Journal of clinical endocrinology and metabolism · 2023Article
- Hypoxia, acidification and oxidative stress in cells cultured at large distances from an oxygen source.Scientific reports · 2022Article
- Modeling acid-base balance during continuous kidney replacement therapy.Journal of clinical monitoring and computing · 2022Article
- A physiology-based mathematical model for the selection of appropriate ventilator controls for lung and diaphragm protection.Journal of clinical monitoring and computing · 2021Article
- Quantifying HPhysiological reports · 2021Article
- Arterial Blood Gas: Bowling Wide and Poor Wicketkeeping.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Peter Stewart added controversy to an already troubled subject when he entered the clinical acid-base arena. His approach puts water dissociation at the centre of the acid-base status of body fluids. It is based on six simultaneous equations, incorporating the Laws of Mass Action, Mass Conservation, and Electrical Neutrality. Together with Gibbs-Donnan equilibria, these equations explain the diagnostically important PaCO(2)/pH relationship, and improve understanding of the physiologic basis of traditional acid-base approaches. Spin-offs have included new scanning tools for unmeasured ions, in particular the 'strong ion gap' and 'net unmeasured ions'. The most controversial feature is the designation of pH and bicarbonate concentrations as dependent variables, answerable exclusively to three independent variables. These are the strong ion difference (SID), the total concentration of non-volatile weak acid (A(TOT)), and PCO(2). Aspects of this assertion conflict with traditional renal physiology, and with current models of membrane H(+)/base transporters, oxidative phosphorylation, and proton and bicarbonate ionophores. The debate in this area is ongoing. Meanwhile, Stewart-style diagnostic and decision support systems such as the 'Strong Ion Calculator' and the web-site www.acidbase.org are now appearing.
Identifiers
19565024PMC2702213What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.