The hidden secrets of a neutral pH-blood gas analysis of postoperative patients according to the Stewart approach

Acid-Base Analysis in the Operating Room: A Bedside Stewart Approach

The bedside Stewart approach to acid–base disorders is a simple, pragmatic tool that can assist anesthesiologists in analyzing and managing acid–base changes in the operating room, particularly metabolic acidosis.

Hyperlactatemia and other perioperative metabolic disturbances in neuroanesthesia

PURPOSE OF REVIEW

The concept of 'brain-body cross-talking' has gained growing interest in the last years. The understanding of the metabolic disturbances (e.g., hypernatraemia/hyponatraemia and hyperlactatemia) in neurosurgical patients has improved during the last years.

RECENT FINDINGS

The impact of elevated lactate without acidosis in neurosurgical patients remains controversial. The pathophysiology of inappropriate secretion of antidiuretic hormone (SIADH) has become clearer, whereas the diagnosis of cerebral salt wasting should be used more carefully.

SUMMARY

These findings will contribute to a better understanding of the pathophysiology involved and enable better prevention and therapy where possible in clinical practice.