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Respiratory Acidosis

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Respiratory Acidosis

  • 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
  • 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
  • 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
  • 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