ICU rounds


Winters’s formula revisited

Jonathan Kopel BS, Gilbert Berdine MD

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.

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

Article citation: Kopel J, Berdine G. Winters’s formula revisited. The Southwest Respiratory and Critical Care Chronicles 2019;7(27):43–49.

From: The Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas.

Submitted: 9/6/2018

Accepted: 12/26/2018

Reviewer: Kenneth Nugent MD

Conflicts of interest: none

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.