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Related Experiment Video

Updated: Jun 22, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

The Stewart approach--one clinician's perspective.

T John Morgan¹

¹Intensive Care Unit, Mater Adult Hospital, Mater Health Services, South Brisbane, Qld 4101, Australia. john.morgan@mater.org.au

The Clinical Biochemist. Reviews

|July 1, 2009

Summary

Peter Stewart

Area of Science:

Clinical biochemistry
Physiology
Medical diagnostics

Background:

The clinical acid-base arena is complex and often debated.
Traditional approaches to acid-base balance have limitations.
Peter Stewart's novel approach centers on water dissociation.

Purpose of the Study:

To present Peter Stewart's acid-base approach.
To explain its theoretical underpinnings and clinical implications.
To highlight the ongoing debate and emerging tools.

Main Methods:

Utilizes six simultaneous equations based on Mass Action, Mass Conservation, and Electrical Neutrality.
Incorporates Gibbs-Donnan equilibria.
Identifies three independent variables: strong ion difference (SID), total non-volatile weak acid (A(TOT)), and PCO(2).

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Main Results:

Explains the PaCO(2)/pH relationship and enhances understanding of traditional methods.
Introduces new diagnostic tools like the 'strong ion gap' and 'net unmeasured ions'.
Designates pH and bicarbonate as dependent variables, influenced by three independent variables.

Conclusions:

Stewart's model offers a new perspective on acid-base status, emphasizing water dissociation.
It challenges traditional renal physiology and transporter models, sparking ongoing debate.
Diagnostic tools and support systems based on this model are emerging.