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Derivative instruments - (Summary of Income and Expense Line Items) (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Derivative [Line Items]      
Revenue from Contract with Customer, Including Assessed Tax $ 26,323 $ 25,979 $ 25,424
Other (expense) income, net (814) 259 256
Interest expense, net (1,406) (1,197) (1,262)
Interest rate swap agreements [Member]      
Derivative [Line Items]      
Gains (losses) on fair value hedging relationships, Hedged Items 716 281 315
Gains (losses) on fair value hedging relationships, Derivatives designated as hedging instruments (636) (192) (204)
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Cross-currency swap contracts      
Derivative [Line Items]      
Other (expense) income, net (233) (245) 323
Product sales      
Derivative [Line Items]      
Revenue from Contract with Customer, Including Assessed Tax 24,801 24,297 24,240
Product sales | Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Foreign currency forward contracts      
Derivative [Line Items]      
Revenue from Contract with Customer, Including Assessed Tax $ 231 $ (8) $ 178