Health Encyclopedia

Respiratory acidosis

Definition

Respiratory acidosis is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This disrupts the body's acid-base balance. Body fluids become too acidic.

Alternative Names

Ventilatory failure; Respiratory failure; Acidosis - respiratory

Causes, incidence, and risk factors

Causes of respiratory acidosis include:

Diseases of the airways (such as asthma and chronic obstructive lung disease), which send air into and out of the lungs
Diseases of the chest (such as scoliosis) that make the lungs less efficient at filling and emptying
Disease of the nerves and muscles that "signal" the lungs to inflate or deflate
Drugs (including powerful pain medicines such as narcotics, and "downers" such as benzodiazepines), especially when combined with alcohol
Severe Obesity

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

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

Symptoms

Symptoms may include:

Confusion
Easy fatigue
Lethargy
Shortness of breath
Sleepiness

Signs and tests

A chest x-ray or CT scan is a helpful way of checking the lung's appearance without having to biopsy it.

Pulmonary function tests are a series of breathing tests that evaluate lung capacity.

An arterial blood gas test involves having blood drain and directly measuring the amounts of oxygen, carbon dioxide, and acids.

Treatment

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

Bronchodilator drugs to reverse some airway obstruction
Methods to stop smoking
Non-invasive positive-pressure ventilation (sometimes called CPAP or BiPAP) or mechanical ventilation if needed
Oxygen if the blood oxygen level is low

Expectations (prognosis)

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

Complications

Poor organ function
Respiratory failure
Shock

Calling your health care provider

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

Call your health care provider if you have symptoms of lung disease.

Prevention

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

Losing weight may help prevent obesity hypoventilation syndrome.

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

References

Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000: 191-192.

Marx J., Hockberger R, Walls R Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby; 2005.

Ford MD, Clinical Toxicology. 1st ed. Philadelphia, Pa: WB Saunders; 2001:92.

Review Date:11/12/2007
Reviewed By:Andrew Schriber, M.D., F.C.C.P., Specialist in Pulmonary, Critical Care, and Sleep Medicine, Virtua Memorial Hospital, Mount Holly, New Jersey. Review provided by VeriMed Healthcare Network.

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