Winters’s formula revisited

  • Jonathan Kopel
  • Gilbert Berdine
Keywords: Lawrence Henderson, Horace Davenport, Robert Winters, Henderson-Hasselbalch equation, acid-base physiology, Winters’s formula, and Davenport diagrams

Abstract

The fundamentals of acid-base physiology underlie numerous pathological processes and treatments. The modern methods used to evaluate a patient’s acid-base status are based on Lawrence J. Henderson’s early work on the thermodynamics and kinetics of acid-base reactions. Henderson’s work eventually culminated in two groundbreaking papers advancing our understanding and approaches to measuring a patient’s acid-base status. However, Henderson’s formula failed to provide information on the secondary compensation to primary acid-base disturbances. During the mid-20th century, two physicians, Horace W. Davenport and Robert W. Winters, revealed the physiological mechanisms and provided a mathematical description of acid-base physiology. In this paper, we discuss the history of acid-base physiology and revisit Winters’s formula with respect to extreme disturbances in pH.

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References

Berend K, de Vries APJ, Gans ROB. Physiological approach to assessment of acid–base disturbances. New Engl J Med 2014;371(15):1434-1445.

Whittier WL, Rutecki GW. Primer on clinical acid-base problem solving. Disease-a-Month 2004;50(3):122-162.

Henderson LJ. Concerning the relationship betwen the strength of acids and their capacity to preserve neutrality. American J Physiology-Legacy Content 1908;21(2):173-179.

de Levie R. The Henderson-Hasselbalch equation: its history and limitations. J Chemical Education 2003;80(2):146.

Henderson LJ. The theory of neutrality regulation in the animal organism. American J Physiology-Legacy Content 1908;21(4):427-448.

Devenport HW. The ABC of Acid-Base Chemistry. Sixth ed. The University of Chicago: The University of Chicago Press; 1974.

Oransky I. Horace W Davenport obituary. The Lancet 2005;366.

Wood CM, McMahon BR, McDonald DG. An analysis of changes in blood pH following exhausting activity in the starry flounder, platichthys stellatus. J Experimental Biology 1977;69:173-185.

Morgan HG. Acid-base balance in blood. British J Anaesthesiology 1969;41:196-211.

Piiper J, Meyer M, Drees F. Hydrogen ion ballance in the elasmobranch Scyliorhinus stellaris after exhausting activity. Respiration Physiology 1972;16(3):290-303.

Albert MS, Dell RB, Winters RW. Quantitative displacement of acid-base equilibrium in metabolic acidosis. Ann Intern Med 1967;66(2):312.

Engel K, Dell RB, Rahill WJ, Denning CR, Winters RW. Quantitative displacement of acid-base equilibrium in chronic respiratory acidosis. J Applied Physiology 1968;24(3):288-295.

Published
2019-01-18
How to Cite
Kopel, J., & Berdine, G. (2019). Winters’s formula revisited. The Southwest Respiratory and Critical Care Chronicles, 7(27), 43-49. https://doi.org/10.12746/swrccc.v7i27.512