Respiratory acidosis – causes, symptoms, treatment

Respiratory acidosis is most often caused by an excessive retention of the gas in the blood, such as carbon dioxide. Too much carbon dioxide can cause respiratory acidosis, which may be acute or, if the condition lasts longer, chronic. Treatment of respiratory acidosis is based on finding the underlying disease. Symptoms of respiratory acidosis can include distressing central nervous system symptoms such as hallucinations and accompanying psychosis. What are the causes of respiratory acidosis?

Respiratory acidosis occurs when the process of removing carbon dioxide from the lungs is impaired. In such a situation, hypercapnia develops very quickly, i.e. the partial pressure of carbon dioxide increases. Hypercapnia is always accompanied by hypoxemia, which is a reduction in the partial pressure of oxygen. As a result of hypercapnia and hypoxemia, alveolar ventilation decreases, which – developing rapidly – leads to acute respiratory or chronic acidosis that lasts longer than a day.

Respiratory acidosis – symptoms

As mentioned, respiratory acidosis can take two forms – it can take the acute form, during which there is a sudden retention of carbon dioxide in the blood with a concomitant drop in blood pH below the physiological level of about 7,35. The second form of respiratory acidosis is the chronic form, which takes a little longer to develop, symptoms may not appear until 5 days later. The diagnosis of respiratory acidosis on the basis of symptoms is quite difficult, however, in acute respiratory acidosis the appearance of cyanosis is quite characteristic, which is a bluish discoloration of the mucous membranes and skin integuments. Acute respiratory acidosis has a negative impact on the central nervous system, which can cause anxiety, anxiety, irritability, various types of psychosis, and even hallucinations or delusions. In addition, a sharp increase in the pressure of the accumulated carbon dioxide in the blood can lead to the patient becoming unconscious. In turn, chronic respiratory acidosis is characterized by headaches, weariness and apathy, drowsiness, difficulty concentrating, and in extreme cases may cause coma. Symptoms of chronic respiratory acidosis are also cyanosis, which also occurs in acute respiratory acidosis, and hypoxemia, which consists in lowering the partial pressure of oxygen in the blood. Respiratory acidosis is also manifested by conjunctival hyperemia and an increase in the partial pressure of carbon dioxide (hypercapnia). In addition, respiratory acidosis may manifest itself as excessive muscle contractions caused by increased urinary excretion of magnesium, calcium or phosphate.

Respiratory acidosis – causes

Respiratory acidosis results from hypercapnia, which is an increase in the partial pressure of carbon dioxide in the blood. The pressure rises above 45 mm Hg. The partial pressure increases most often as a result of impeded alveolar ventilation and, although less often – as a result of the overproduction of carbon dioxide. However, the causes of acidosis most often arise from various respiratory diseases. These causes can cause both acute and chronic respiratory acidosis. These will be, for example, diseases of the lung parenchyma, pleura, chest structures, obstruction of the lower respiratory tract. Respiratory acidosis can also be caused by such factors as: diseases of the central nervous system, nerves, muscles, sepsis, shock, sudden cardiac arrest. In addition, respiratory acidosis causes cardiac arrhythmias and an increase in blood cortisol levels. In addition, respiratory acidosis can be caused by antidepressants that affect the respiratory center or by muscle relaxants. Respiratory acidosis may also be caused by excess body weight and obesity, or at night apnea, which leads to obstruction (narrowing) of the airways.

Respiratory acidosis – treatment

Treatment of respiratory acidosis must also include appropriate diagnostic tests. These include the measurement of arterial blood gases. In the presence of respiratory acidosis, hypercapnia (increase in the partial pressure of carbon dioxide) and hypoxemia (decrease in the partial pressure of oxygen) are observed. The concentration of glucose, urea and creatinine are also tested. Occasionally, respiratory acidosis is due to the presence of other conditions that you should inform your doctor about. The very treatment of respiratory acidosis is highly dependent on the underlying disease. Therefore, the treatment used is based on finding the cause of the disorder. In order to restore the proper diffusion of gases through the alveoli, agents that induce bronchodilation are used. In the treatment of respiratory acidosis, glucocorticosteroids are used primarily, sometimes oxygen therapy or mechanical ventilation.

Respiratory acidosis – prognosis

The prognosis of respiratory acidosis depends largely on the systemic disease that may cause the symptoms mentioned above.

Respiratory acidosis – prevention

There are no specific indications that would allow the prevention of ketoacidosis, as it is a disease of various etiology.

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