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.
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.