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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
)
Asthma
Asthma is a disease that causes the airways of the lungs to swell and narrow. It leads to wheezing, shortness of breath, chest tightness, and coughi...
ImageRead Article Now Book Mark ArticleCOPD
Chronic obstructive pulmonary disease (COPD) is a common lung disease. Having COPD makes it hard to breathe. There are two main forms of COPD:Chroni...
ImageRead Article Now Book Mark Article -
Diseases of the lung tissue (such as
pulmonary fibrosis
, which causes scarring and thickening of the lungs)
Pulmonary fibrosis
Idiopathic pulmonary fibrosis is scarring or thickening of the lungs without a known cause.
ImageRead Article Now Book Mark Article - 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
Blood gas
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
ImageRead Article Now Book Mark Article - Basic metabolic panel
-
Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
ImageRead Article Now Book Mark Article - CT scan of the chest
-
Pulmonary function test
to measure breathing and how well the lungs are functioning
Pulmonary function test
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
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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
CPAP
CPAP stands for continuous positive airway pressure. CPAP pumps air under pressure into the airway of the lungs, keeping the windpipe open during sl...
ImageRead Article Now Book Mark Article - Oxygen if the blood oxygen level is low
-
Treatment to
stop smoking
Stop smoking
There are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...
ImageRead Article Now Book Mark Article - 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
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means that the cells and organs...
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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
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.
