MEM-EM: The Memorising Emergency Medicine Podcast

Mastering the Acid - Base Balance in the Critically Unwell


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These sources compare clinical methodologies for evaluating acid-base homeostasis, specifically contrasting the traditional Henderson-Hasselbalch model with the Stewart physicochemical approach. The Stewart model identifies Strong Ion Difference (SID)weak acids like albumin, and carbon dioxide as the three independent variables that govern blood pH. While the traditional method remains common, researchers emphasize that the Stewart approach more accurately identifies complex metabolic disorders in critically ill patients, such as those caused by hyperchloremia or hypoalbuminemia. Clinical studies highlight that using albumin-corrected anion gaps can bridge the diagnostic gap when sophisticated Stewart-based calculators are unavailable. 

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MEM-EM: The Memorising Emergency Medicine PodcastBy MEM-EM