Certain biases in the way we think in medicine are so pervasive and so misleading that I'm going to make a special section on this blog for them: The Specious Ideas Series. We'll begin with my favorite, the approach to hypercarbia (high CO2) and acidosis (low pH) both in and out of the ICU.
Patients with serious illness often have derangements in PaCO2 (arterial partial pressure of CO2; hereinafter abberviated CO2) and pH. But it does not necessarily follow that patients are experiencing physiological stress because of CO2 and pH, and it likewise does not follow that actions to normalize these values will make patients better. Indeed, such actions are often not only a distraction and a waste of time, but they can also be harmful.
Here's some bad acid and CO2
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