Respiratory Acidosis: Causes, Symptoms & Treatment

Overview

• Definition: Respiratory acidosis occurs when the lungs can't remove enough carbon dioxide, causing the blood to become acidic.
• pH Balance: Blood requires a normal pH range of 7.35 to 7.45.
• Types:
  • Acute: Rapid CO2 buildup in the lungs.
  • Chronic: Gradual development, possibly with acute episodes.

Affected Individuals

• Can affect anyone, often due to:
  • Lung diseases
  • Respiratory muscle fatigue
  • Airflow obstructions

Symptoms

• Initial Symptoms:
  • Anxiety
  • Blurred vision
  • Confusion
  • Cyanosis (discolored skin)
  • Headache
  • Shortness of breath
  • Wheezing
• Severe Symptoms:
  • Extreme fatigue
  • Muscle twitching
  • Behavioral changes
  • Seizure
  • Coma
• Chronic Symptoms:
  • Daytime fatigue
  • Heart failure
  • High blood pressure
  • Polycythemia
  • Loss of coordination
  • Memory loss

Causes

• Chronic:
  • Acute pulmonary edema
  • ALS
  • Asthma
  • COPD
  • Neuromuscular disorders (e.g., MS, muscular dystrophy)
  • Obesity
  • Pulmonary fibrosis
  • Scoliosis
• Acute:
  • Asthma
  • COPD
  • Substance overuse (alcohol, amphetamines, opioids)
  • Emphysema
  • Pneumonia
  • Sleep apnea

Diagnosis and Tests

• Diagnostic Methods:
  • Symptom history and physical examination.
  • Tests:
    • Arterial blood gas (ABG)
    • Basic metabolic panel (BMP)
    • Chest X-ray
    • CO2 blood test
    • CT scan
    • Electrolyte panel
    • Pulmonary function tests (PFTs)

Management and Treatment

• First-line Treatments:
  • Treat underlying conditions
  • CPAP for sleep apnea
  • Mechanical ventilation for severe cases
  • Medications for lung/airway conditions
  • Oxygen therapy
• Medications:
  • Antibiotics for bacterial infections
  • Bronchodilators
  • Corticosteroids
  • Diuretics
  • Naloxone for suspected opioid overdose
  • Smoking cessation aids

Prevention

• Stop smoking or using tobacco products
• Regular exercise
• Maintain a healthy weight
• Use CPAP machines as prescribed
• Take sedatives cautiously

Prognosis

• Varies based on treatment response and underlying causes.
• Medical consultation is essential for management.

Living With Respiratory Acidosis

• Seek medical assistance for worsening symptoms.
• Discuss treatment and condition questions with healthcare providers.

Additional Information

• Respiratory Acidosis vs. Alkalosis: Acidosis is due to CO2 retention; Alkalosis results from CO2 removal due to hyperventilation.
• Respiratory vs. Metabolic Acidosis: Metabolic acidosis involves acid buildup due to kidney issues or excess acid production.

Note from Cleveland Clinic

• Respiratory acidosis should not be ignored and requires medical attention to avoid being fatal.
• Cleveland Clinic offers respiratory therapy to improve daily living quality.