Vnitr̆ní lékar̆ství
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Vnitr̆ní lékar̆ství · Jul 2004
[Analysis and adjustment of acid-base disturbances according to the Stewart-Fencl principle].
In 1983, P. J. Stewart proposed a new approach for evaluation of acid-base balance of body fluids. ⋯ The change of SID value is a consequence of either dehydration (alkalosis) or hyperhydration (acidosis). Other mechanisms of SID deviation are either changes of serum chloride concentration (an increase causes acidosis, a decrease causes alkalosis) or an increase of concentrations of substances not routinely measured (ketones, lactate, exogenous acids). [Atot] value is determined mainly by the serum albumin concentration (alkalosis in hypoalbuminemia, acidosis in hyperproteinemia). The Stewart-Fencl approach to acid-base balance enables to understand and predict what happens to hydrogen ions in body fluids and to control the pH abnormalities quantitatively.