Acid–Base Tutorial

I met “Grog” once, very briefly, at a Society for Technology in Anesthesia meeting. It was obvious that the speakers thought highly of him. After reviewing his Acid–Base Tutorial Web site, I believe that I know him better and understand how he has gained the admiration and respect of his colleagues.

Dr. Grogono has been teaching and writing about acid–base physiology for all his professional life. He says, modestly, that he has been “trying to make the subject interesting and easy to understand—partly for [him]self, partly for others.” He tries hard to express complicated ideas as clearly and simply as possible. For example, he decries Hasselbach’s complication of the Henderson equation, stating that it adds nothing except “obfuscation and unnecessary exam questions.” He recently retired from his position as Chair of the Department of Anesthesiology at Tulane University in New Orleans, Louisiana, which has given him time to redevelop this Web site, which was originally written in 1996 and revised in 1998.

The site opens with a matrix of brightly colored rectangles, reminiscent of a child’s building blocks, with titles such as “Terminology” and “Acid Production.” Running the mouse over the images produces a more detailed explanation of each link. Grogono’s image winks as the mouse rolls over it, a reassuring sign that the site is not as dry as it might be.

There are clear, brief accounts of topics, such as “Respiratory Treatment,” written at a level suitable for medical students or residents. Throughout the site, small, simple graphics are used to enliven the pages and demonstrate key points.

There are three versions of the current Web site, one with frames, one without, and one with minimal graphics. It is always helpful for a Web site to allow a user these choices.

The site has not been sponsored by anyone. There is no commercial influence, apart from the offer of plastic cards of the relevant diagrams, available from the author for $1 each, plus $4 postage and packing per order.

The site makes use of the Web by incorporating JavaScript and Java Applets to produce “Interactive Acid–Base Pages,” which allow readers to experiment with the equations and graphs associated with acid–base physiology. For example, one can interact with the Henderson equation to get an idea of how a change in one part of the equation would result in changes in any other part, or experiment with writing reports on a particular set of laboratory results.

It is impressive that one person has the skills necessary to understand a topic, the confidence and linguistic ability to explain it clearly, the ability to produce a clear and user-friendly Web site, and the computing knowledge to produce (admittedly with substantial help) interactive simulations of a physiologic situation.

This site is a fairly easy way to revise the basics of acid–base physiology. It is highly recommended to medical students, anesthesiology residents, and their teachers. It would be of benefit to anyone who needs to brush up on the topic and to anyone interested in a good example of how to use the Internet to provide new educational tools. It goes as far as possible toward making the abstract concepts of acid and base physiology easy to understand and is a fitting culmination to Dr. Grogono’s years of teaching the subject.