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==Overview==
==Overview==
Winter's formula is a formula to analyze the adequacy of [[respiratory compensation]] in the presence of a primary [[metabolic acidosis]].
Winters' formula is a formula to assess the adequacy of [[respiratory compensation]] in the presence of a primary [[metabolic acidosis]].


==Historical Perspective==
==Historical Perspective==
Winter's formula, named after Robert W. Winters,<ref name="pmid6016545">{{cite journal | author = Albert MS, Dell RB, Winters RW | title = Quantitative displacement of acid-base equilibrium in metabolic acidosis | journal = [[Annals of Internal Medicine]] | volume = 66 | issue = 2 | pages = 312–22 | year = 1967 | month = February | pmid = 6016545 | doi = | url = http://www.annals.org/article.aspx?volume=66&page=312 | issn = }}</ref><ref name="pmid5775132">{{cite journal | author = Asch MJ, Dell RB, Williams GS, Cohen M, Winters RW | title = Time course for development of respiratory compensation in metabolic acidosis | journal = [[The Journal of Laboratory and Clinical Medicine]] | volume = 73 | issue = 4 | pages = 610–5 | year = 1969 | month = April | pmid = 5775132 | doi = | url = | issn = }}</ref> is a formula used to evaluate [[respiratory compensation]] when analyzing acid-base disorders and a [[metabolic acidosis]] is present.<ref name="urlCase 1: Acid Base Tutorial, University of Connecticut Health Center">{{Cite web|url=http://fitsweb.uchc.edu/student/selectives/TimurGraham/Case_1.html |title=Case 1: Acid Base Tutorial, University of Connecticut Health Center |work= |accessdate=2009-05-09}}</ref><ref name="urlAcid-Base Disorders: Acid-Base Regulation and Disorders: Merck Manual Professional">{{Cite web|url=http://www.merck.com/mmpe/sec12/ch157/ch157b.html |title=Acid-Base Disorders: Acid-Base Regulation and Disorders: Merck Manual Professional |work=|accessdate=2009-05-09}}</ref>  
Winters' formula, named after Robert W. Winters,<ref name="pmid6016545">{{cite journal | author = Albert MS, Dell RB, Winters RW | title = Quantitative displacement of acid-base equilibrium in metabolic acidosis | journal = [[Annals of Internal Medicine]] | volume = 66 | issue = 2 | pages = 312–22 | year = 1967 | month = February | pmid = 6016545 | doi = | url = http://www.annals.org/article.aspx?volume=66&page=312 | issn = }}</ref><ref name="pmid5775132">{{cite journal | author = Asch MJ, Dell RB, Williams GS, Cohen M, Winters RW | title = Time course for development of respiratory compensation in metabolic acidosis | journal = [[The Journal of Laboratory and Clinical Medicine]] | volume = 73 | issue = 4 | pages = 610–5 | year = 1969 | month = April | pmid = 5775132 | doi = | url = | issn = }}</ref> is a formula used to evaluate [[respiratory compensation]] when analyzing acid-base disorders and a [[metabolic acidosis]] is present.<ref name="urlCase 1: Acid Base Tutorial, University of Connecticut Health Center">{{Cite web|url=http://fitsweb.uchc.edu/student/selectives/TimurGraham/Case_1.html |title=Case 1: Acid Base Tutorial, University of Connecticut Health Center |work= }}</ref><ref name="urlAcid-Base Disorders: Acid-Base Regulation and Disorders: Merck Manual Professional">{{Cite web|url=http://www.merck.com/mmpe/sec12/ch157/ch157b.html |title=Acid-Base Disorders: Acid-Base Regulation and Disorders: Merck Manual Professional |work=}}</ref>  


==Interpretation==
==Winters' formula==
Winter's formula can be given as
Winters' formula can be given as


P<sub>CO2</sub> = (1.5 x HCO<sub>3</sub><sup>-</sup>) + 8 ± 2
<table style="border:1px solid black"><tr><td>P<sub>CO<sub>2</sub></sub> = 1.5 x [HCO<sub>3</sub><sup>-</sup>] + 8 ± 2</table>


where HCO3<sup>-</sup> is given in units of mEq/L and P<sub>CO2</sub> will be in units of mm Hg.
where HCO3<sup>-</sup> is given in units of mEq/L and P<sub>CO<sub>2</sub></sub> will be in units of mm Hg.


Winter's formula gives an expected value for the patient's P<sub>CO2</sub>; the patient's measured P<sub>CO2</sub> is then compared to this.
==Interpretation==
Winters' formula gives an expected value for the patient's P<sub>CO2</sub>; the patient's measured P<sub>CO2</sub> is then compared to this.
* If the two values correspond, respiratory compensation is considered to be adequate.
* If the two values correspond, respiratory compensation is considered to be adequate.
* If the measured P<sub>CO2</sub> is higher than the calculated value, there is also a primary respiratory acidosis.
* If the measured P<sub>CO2</sub> is higher than the calculated value, there is also a primary respiratory acidosis.

Latest revision as of 21:49, 4 August 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Winters' formula is a formula to assess the adequacy of respiratory compensation in the presence of a primary metabolic acidosis.

Historical Perspective

Winters' formula, named after Robert W. Winters,[1][2] is a formula used to evaluate respiratory compensation when analyzing acid-base disorders and a metabolic acidosis is present.[3][4]

Winters' formula

Winters' formula can be given as

PCO2 = 1.5 x [HCO3-] + 8 ± 2

where HCO3- is given in units of mEq/L and PCO2 will be in units of mm Hg.

Interpretation

Winters' formula gives an expected value for the patient's PCO2; the patient's measured PCO2 is then compared to this.

  • If the two values correspond, respiratory compensation is considered to be adequate.
  • If the measured PCO2 is higher than the calculated value, there is also a primary respiratory acidosis.
  • If the measured PCO2 is lower than the calculated value, there is also a primary respiratory alkalosis.

References

  1. Albert MS, Dell RB, Winters RW (1967). "Quantitative displacement of acid-base equilibrium in metabolic acidosis". Annals of Internal Medicine. 66 (2): 312–22. PMID 6016545. Unknown parameter |month= ignored (help)
  2. Asch MJ, Dell RB, Williams GS, Cohen M, Winters RW (1969). "Time course for development of respiratory compensation in metabolic acidosis". The Journal of Laboratory and Clinical Medicine. 73 (4): 610–5. PMID 5775132. Unknown parameter |month= ignored (help)
  3. "Case 1: Acid Base Tutorial, University of Connecticut Health Center".
  4. "Acid-Base Disorders: Acid-Base Regulation and Disorders: Merck Manual Professional".

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