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In view of the plethora of published material available on this area, the author justifies yet another contribution by alluding to the excessive complexities and uneven literary quality of existing texts. Unfortunately, Dr. Tuller's approach is excessively simplified, in this reviewer's opinion.
He suggests that plasma [HCO3-] is never directly altered by changes in ventilation because the bicarbonate ion is not volatile. If this were indeed correct, then the PCO2 would inform us about alveolar ventilation, whereas the [HCO3-] would be a purely metabolic index. Unfortunately, in the presence of protein buffers in the blood, [HCO3-] is acutely altered by
Acid-Base Homeostasis and Its Disorders. Use of Arterial Blood Gas Analysis in Diagnosis and Therapy.. Ann Intern Med. ;75:486. doi: 10.7326/0003-4819-75-3-486_1
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Published: Ann Intern Med. 1971;75(3):486.
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