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lüll Bench-to-bedside review: a brief history of clinical acid-base Story DACrit Care 2004[Aug]; 8 (4): 253-8The history of assessing the acid-base equilibrium and associated disorders is intertwined with the evolution of the definition of an acid. In the 1950s clinical chemists combined the Henderson-Hasselbalch equation and the Bronsted-Lowry definition of an acid to produce the current bicarbonate ion-centred approach to metabolic acid-base disorders. Stewart repackaged pre-1950 ideas of acid-base in the late 1970s, including the Van Slyke definition of an acid. Stewart also used laws of physical chemistry to produce a new acid-base approach. This approach, using the strong ion difference (particularly the sodium chloride difference) and the concentration of weak acids (particularly albumin), pushes bicarbonate into a minor role as an acid-base indicator rather than as an important mechanism. The Stewart approach may offer new insights into acid-base disorders and therapies.|*Acid-Base Equilibrium[MESH]|*Blood Gas Analysis[MESH]|Acid-Base Imbalance/*diagnosis/history/metabolism[MESH]|Acids/blood/metabolism[MESH]|Bicarbonates/blood/metabolism[MESH]|History, 20th Century[MESH]|Humans[MESH]|Ion Exchange[MESH]|Point-of-Care Systems[MESH] |