Winters' Formula for Metabolic Acidosis Compensation

id

117

full_title

Winters' Formula for Metabolic Acidosis Compensation

short_title

Winters' Formula

med_description

Calculates the expected pCO₂ compensation in a purely metabolic acidosis.

description

The Winters’ Formula for Metabolic Acidosis Compensation Calculates the expected pCO₂ compensation in a purely metabolic acidosis.

keywords

winters formula, metabolic acidosis, winters formula score, winters' formula calc, winters acidosis calc, winters acidosis score, winters compensation, acidosis calc, acidosis compensation, acidosis score, acidosis compensation formula, acidosis formula, acidosis compensation, metabolic acidosis score, metabolic acidosis calc, metabolic acidosis formula, respiratory compensation acidosis, pCO2 compensation acidosis, pCO2 compensation metabolic acidosis

complaint

[ "AMS", "Intoxication/Overdose", "Shortness of Breath" ]

formula

Expected pCO₂ = 1.5 ×HCO₃- + 8 ± 2 Note: although the original Winters formula used a standard error of ±2, newer data suggest that pCO₂ may vary up to ±5 (Adrogué and Madias 2010).

evidence

measurements

[ { "name": "Bicarbonate", "unit": "bicarb", "error_min": "1", "error_max": "100", "warn_min": "4", "warn_max": "60", "conversion": "1", "normal_max_si": "28", "normal_max_us": "28", "normal_min_si": "23", "normal_min_us": "23", "units_si": "mmol/L", "units_us": "mEq/L" } ]

information

refrences

{ "Clinical Practice Guidelines": [ { "href": "", "text": "" } ], "Manufacturer Website": [ { "href": "", "text": "" } ], "Original/Primary Reference": [ { "href": "https://annals.org/article.aspx?articleid=681186", "text": "Albert MS, Dell RB, Winters RW. Quantitative Displacement of Acid-Base Equilibrium in Metabolic Acidosis. Ann Intern Med. 1967;66:312-322. doi:10.7326/0003-4819-66-2-312." } ], "Other References": [ { "href": "https://jasn.asnjournals.org/content/21/6/920", "text": "Adrogué HJ, Madias NE. Secondary responses to altered acid-base status: the rules of engagement. J Am Soc Nephrol. 2010;21(6):920-3." } ], "Outcomes": [ { "href": "", "text": "" } ], "Validation": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/5775132", "text": "Asch MJ, Dell RB, Williams GS, Cohen M, Winters RW. Time course for development of respiratory compensation in metabolic acidosis. J Lab Clin Med. 1969 Apr;73(4):610-5." } ], "Validations": [] }

pearls

usecase

• A patient with a suspect pure metabolic acidosis.
• A patient with a mixed acidosis to determine level of compensation.

reasons

In a compensated state, a patient with a metabolic acidosis should be able to compensate by developing a respiratory alkalosis. Winters' Formula predicts this level of “appropriate” compensation.

next_advice

• Users may be interested in the MDCalc ABG Analyzer which can attempt to assess for different forms of acid-base disorders.
• The Anion Gap calculator can also help determine the type of acidosis (gap vs. non-gap).

next_actions

next_management

diseases

[ "Acid-Base Disturbance" ]

instructions

published

2022-04-21T20:28:57.213Z

purpose

[ "Formula" ]

search_terms

[ "abg", "vbg", "winters'", "winters", "gap", "ph", "winters formula", "winters' formula", "metabolic acidosis", "winters formula score", "winters' formula calc", "winters acidosis calc", "winters acidosis score", "winters compensation", "acidosis calc", "acidosis compensation", "acidosis score", "acidosis compensation formula", "acidosis formula", "acidosis compensation", "metabolic acidosis score", "metabolic acidosis calc", "metabolic acidosis formula", "respiratory compensation acidosis", "pCO2 compensation acidosis", "pCO2 compensation metabolic acidosis" ]

seo

{ "keywords_en": "winters formula, metabolic acidosis, winters formula score, winters' formula calc, winters acidosis calc, winters acidosis score, winters compensation, acidosis calc, acidosis compensation, acidosis score, acidosis compensation formula, acidosis formula, acidosis compensation, metabolic acidosis score, metabolic acidosis calc, metabolic acidosis formula, respiratory compensation acidosis, pCO2 compensation acidosis, pCO2 compensation metabolic acidosis", "meta_description_en": "The Winters’ Formula for Metabolic Acidosis Compensation Calculates the expected pCO₂ compensation in a purely metabolic acidosis." }

specialty

[ "Critical Care", "Critical Care (Pediatric)", "Emergency Medicine", "Endocrinology", "Hospitalist Medicine", "Internal Medicine", "Nephrology", "Toxicology" ]

departments

[ "Endocrine and Metabolic", "Renal" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 2045, "short_title_en": "Urine Anion Gap", "slug": "urine-anion-gap" }, { "calcId": 1669, "short_title_en": "Anion Gap", "slug": "anion-gap" }, { "calcId": 10181, "short_title_en": "METS-IR ", "slug": "metabolic-score-insulin-resistance-mets-ir" } ]

ismed

false

section

[ "whenToUseViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "endocrine", "urology" ]

cleaned_use

[ "A patient with a suspect pure metabolic acidosis.", "A patient with a mixed acidosis to determine level of compensation." ]

pub

true