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Respiratory acidosis

Ventilatory failure; Respiratory failure; Acidosis - respiratory

 

Respiratory acidosis is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic.

Causes

 

Causes of respiratory acidosis include:

  • Diseases of the airways (such as asthma and COPD )
  • Diseases of the lung tissue (such as pulmonary fibrosis , which causes scarring and thickening of the lungs)
  • Diseases of the chest (such as scoliosis)
  • Diseases affecting the nerves and muscles that signal the lungs to inflate or deflate
  • Drugs that suppress breathing (including powerful pain medicines, such as narcotics, and "downers," such as benzodiazepines), often when combined with alcohol
  • Severe obesity, which restricts how much the lungs can expand
  • Obstructive sleep apnea

Chronic respiratory acidosis occurs over a long time. This leads to a stable situation, because the kidneys increase body chemicals, such as bicarbonate, that help restore the body's acid-base balance.

Acute respiratory acidosis is a condition in which carbon dioxide builds up very quickly, before the kidneys can return the body to a state of balance.

Some people with chronic respiratory acidosis get acute respiratory acidosis because an illness makes their condition worse.

 

Symptoms

 

Symptoms may include:

  • Confusion
  • Easy fatigue
  • Lethargy
  • Shortness of breath
  • Sleepiness

 

Exams and Tests

 

The health care provider will perform a physical exam and ask about symptoms.

Tests that may be done include:

  • Arterial blood gas , which measures oxygen and carbon dioxide levels in the blood
  • Basic metabolic panel
  • Chest x-ray
  • CT scan of the chest
  • Pulmonary function test  to measure breathing and how well the lungs are functioning

 

Treatment

 

Treatment is aimed at the underlying disease, and may include:

  • Bronchodilator drugs to reverse some types of airway obstruction
  • Noninvasive positive-pressure ventilation (sometimes called CPAP or BiPAP) or a breathing machine, if needed
  • Oxygen if the blood oxygen level is low
  • Treatment to stop smoking
  • For severe cases, a breathing machine might be needed

 

Outlook (Prognosis)

 

How well you do depends on the disease causing the respiratory acidosis.

 

Possible Complications

 

Complications that may result include:

  • Poor organ function
  • Respiratory failure
  • Shock

 

When to Contact a Medical Professional

 

Severe respiratory acidosis is a medical emergency. Seek immediate medical help if you have symptoms of this condition.

Call your provider if you have symptoms of lung disease that suddenly get worse.

 

Prevention

 

DO NOT smoke. Smoking leads to the development of many severe lung diseases that can cause respiratory acidosis.

Losing weight may help prevent respiratory acidosis due to obesity (obesity-hypoventilation syndrome).

Be careful about taking sedating medicines, and never combine these medicines with alcohol.

Use your CPAP device regularly if it's been prescribed for you.

 

 

References

Effros RM, Swenson ER. Acid-base balance. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 7.

Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 118.

 
  • Respiratory system - illustration

    Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

    Respiratory system

    illustration

    • Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Respiratory acidosis

           

             

            Review Date: 8/21/2016

            Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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