Presentation Description / Session Abstract: SID? SIG? Stewart, Fencl, Figge and Constable? If you’ve ever felt intimidated (or bored senseless) by alternatives to the standard Henderson-Hasselbalch approach to acid-base, this is the lecture for you! We will start with a brief (but light-hearted) journey through the history of acid-base physiology, offering a comparison of the bicarbonate-based methods with physiochemical (Stewart) approach to clinical acid-base disorders. We will then discuss how Stewart’s incredibly complicated fourth order polynomial equations can be simplified in ways that are valuable and welcoming to sleep-deprived clinicians looking at critical cases in the middle of the night, using simple, back-of-the-envelope math. There will be interactive examples of how to use a modest chemistry panel (no blood gas required) to assess complex acid-base derangements, and then design elegant, custom fluid plans to address a variety of common problems. At the end of the lecture, participants will feel invigorated and inspired to apply Stewart’s revolutionary approaches to their cases.
Learning Objectives:
Understand the basic concepts of the Stewart Approach to Acid-Base, and why it is profoundly different from the traditional techniques.
Apply a simplified version of the Stewart approach to solve clinical acid-base derangements.
Create custom fluids for patients to correct Stewart imbalances.