IBCC chapter & cast - Approach to pH diagnosis

According to Albert Einstein, “Everything should be made as simple as possible, but not simpler.” This is a similar sentiment to Occam's Razor. Acid-base analysis is a good example of this principle. It's possible to make things extraordinarily fancy and complex. To analyze pH status we could obtain an ABG, complete blood count, calcium, magnesium, phosphate, and albumin levels and feed them all into a supercomputer. However, there's no solid clinical evidence that fancy models are clinically superior to simple models.

From a theoretical standpoint, fancy models (e.g. Stewart's Physiochemical model) are undoubtedly superior. The physical chemist will look down upon traditional acid-base analysis as pedestrian (which is true, from a physical chemistry standpoint). However, for worker bee clinicians, we need something which can be applied in a uniform and reliable fashion without requiring a ton of labs. This chapter describes such an approach. It's a bit old-fashioned and simple but make no mistake – it cuts like a knife.

The IBCC chapters are generally released in quasi-random order. However, in order to try to consolidate an understanding of metabolic pH analysis, the next three sections will sequentially explore various aspects of metabolic pH abnormalities.