In this post I link to and include the Internet Book Of Critical Care‘s [Link is to the IBCC Table of Contents] introduction to the chapters on respiratory alkalosis (hypocapnia) and on respiratory acidosis (hypercapnia).
All that follows is from the introduction to the topic- IBCC – Respiratory alkalosis & respiratory acidosis. August 7, 2021, by Dr. Josh Farkas:
It’s very difficult to write a good chapter about respiratory alkalosis (hypocapnia) or respiratory acidosis (hypercapnia). These states remind me a bit of grand central station, because each encompasses such a broad range of patients with different conditions – who need enormously different treatments. So any discussion of these conditions is by definition a gross generalization. Furthermore, it’s very difficult to tease out the effects of hyper/hypocapnia from the effects of the underlying disease state. And finally, it’s often best to focus on the underlying disease states rather than the hyper/hypocapnia – so an over-emphasis on these topics might even be detrimental!
For the sake of completeness, I have included these chapters. But please be very careful when reading them and applying them to your patients. The key of both hypercapnia and hypercapnia is to diagnose and treat the underlying disease (not necessarily the CO2!). You need to figure out why someone is in Grand Central station and where they are trying to go – only then can you help them.