Acid–base balance during muscular exercise: response to Dr. Böning and Dr. Maassen

Excerpt

We appreciate the interest of Böning and Maassen in our article on exercise and acid–base homeostasis previously published in this journal (Lühker et al. 2017). In their comment, the authors postulate that the Henderson–Hasselbalch approach is more appropriate than Stewart’s approach to acid–base balance and pH regulation. The long-lasting controversy about the superiority of the one compared to the other approach has yielded a bulk of literature and pro-con debates including distinguished researchers and clinicians. Currently, there is no clear evidence which of the ‘modern’ approaches, the Stewart approach or the bicarbonate-centred Henderson–Hasselbalch approach, is the most suitable under all circumstances. One criticism regarding the Henderson–Hasselbalch approach is that it depends solely on bicarbonate (HCO₃⁻), carbon dioxide (CO₂), and the respective dissociation constant. The Stewart approach considers this relationship as important contributor to acid–base balance but expands this description to a total of six physico-chemical equations. …