II. Causes: Acute Respiratory Acidosis

  1. Central Nervous System Depression
    1. Sedative Medications (e.g. Benzodiazepines)
    2. Cerebrovascular Accident
    3. Head Trauma
  2. Neuromuscular Disease
    1. Myasthenia Gravis
    2. Guillain-Barre
    3. Polio
    4. Muscular Dystrophy
    5. Hypokalemia
  3. Impaired lung motion
    1. Pleural Effusion
    2. Pneumothorax
    3. Crush injury
  4. Acute airway obstruction
    1. Foreign Body Aspiration
    2. Tumor
    3. Laryngospasm (e.g. Croup, Epiglottitis)
    4. Bronchospasm (e.g. Asthma)
  5. Acute Respiratory Disease
    1. Severe Pneumonia
    2. Pulmonary Edema

III. Causes: Chronic Respiratory Acidosis

  1. Chronic Obstructive Pulmonary Disease
  2. Pickwickian Syndrome
  3. Chronic Neuromuscular Disease
    1. See Above
  4. Thoracic Cage limitation
    1. Kyphoscoliosis
    2. Scleroderma

IV. Labs

  1. Arterial Blood Gas
    1. Arterial pH decreased
    2. Serum bicarbonate increased
    3. PaCO2 increased
  2. Acute Respiratory Acidosis
    1. PaCO2 increase by 10 mmHg decreases pH 0.08
    2. Bicarbonate increases 1 meq/L per 10 mmHg PaCO2 rise
  3. Chronic Respiratory Acidosis
    1. PaCO2 increase by 10 mmHg decreases pH 0.03
    2. Bicarbonate increases 4 meq/L per 10 mmHg PaCO2 rise

V. References

  1. Arieff (1993) J Crit Illn 8(2): 224-46 [PubMed]
  2. Narins (1982) Am J Med 72:496 [PubMed]
  3. Narins (1980) Medicine 59:161-95 [PubMed]
  4. Ghosh (2000) Fed Pract p. 23-33
  5. Rutecki (Dec 1997) Consultant, p. 3067-74
  6. Rutecki (Jan 1998) Consultant, p. 131-42

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Ontology: Acidosis, Respiratory (C0001127)

Definition (NCI_FDA) A state due to excess retention of carbon dioxide in the body.
Definition (NCI) Acid base imbalance resulting from an accumulation of carbon dioxide secondary to hypoventilation.
Definition (CSP) excess retention of carbon dioxide in the body resulting from ventilatory impairment.
Definition (MSH) Respiratory retention of carbon dioxide. It may be chronic or acute.
Concepts Disease or Syndrome (T047)
MSH D000142
ICD10 E87.2
SnomedCT 12326000
English Acidoses, Respiratory, Acidosis, Respiratory, Respiratory Acidoses, Respiratory Acidosis, ACIDOSIS RESPIRATORY, Hypercapnic Acidosis, hypercapnic acidosis, respiratory acidosis (diagnosis), respiratory acidosis, Acidosis respiratory, Respiratory acidoses, Acidosis, Respiratory [Disease/Finding], acidosis respiratory, RESPIRATORY ACIDOSIS, ACIDOSIS, RESPIRATORY, Respiratory acidosis, Respiratory acidosis (disorder), Respiratory acidosis, NOS
French ACIDOSE RESPIRATOIRE, Acidoses respiratoires, Acidose respiratoire, Acidose gazeuse
Portuguese ACIDOSE RESPIRATORIA, Acidose respiratória, Acidoses respiratórias, Acidose Respiratória
Spanish ACIDOSIS RESPIRATORIA, acidosis respiratoria (trastorno), acidosis respiratoria, Acidosis respiratoria, Acidosis respiratorias, Acidosis Respiratoria
Italian Acidosi respiratorie, Acidosi respiratoria
German Azidose respiratorisch, AZIDOSE RESPIRATORISCH, Respiratorische Azidosen, respiratorische Azidose, Azidose, respiratorische, Respiratorische Azidose
Swedish Acidos, respiratorisk
Japanese コキュウセイアシドーシス, アシドーシス-呼吸性, 呼吸性アシドーシス
Finnish Respiratorinen asidoosi
Czech Acidóza respirační, Respirační acidózy, Respirační acidóza, respirační acidóza, acidóza respirační
Polish Kwasica oddechowa
Hungarian Respiratoricus acidosis, Respiratorikus acidosis, Respiratorikus acidosisok
Norwegian Respiratorisk acidose, Acidose, respiratorisk
Dutch respiratoire acidosen, respiratoire acidose, Acidose, respiratoire, Respiratoire acidose