Respiratory Acidosis: Causes, Symptoms & Treatment

Overview

• Respiratory Acidosis Defined:

  • Occurs when lungs fail to remove enough CO2, leading to acidic blood.
  • Normal blood pH range: 7.35 - 7.45.
  • Develops due to inadequate CO2 removal by lungs.
  • Sudden onset can be fatal; seek immediate help if experiencing difficulty breathing.

• Types of Respiratory Acidosis:

  • Acute Respiratory Acidosis: Rapid CO2 accumulation in lungs.
  • Chronic Respiratory Acidosis: Gradual CO2 buildup.
  • Possible to have both acute and chronic concurrently.

Affected Individuals

• Occurs due to:
  • Lung diseases.
  • Respiratory muscle fatigue.
  • Conditions affecting lung air circulation.

Symptoms and Causes

Symptoms

• Initial symptoms:
  • Anxiety, blurred vision, confusion.
  • Cyanosis (discolored skin), headache, shortness of breath, wheezing.
• Severe/untreated symptoms:
  • Extreme fatigue, muscle twitching, behavioral changes, seizures, coma.
• Chronic symptoms:
  • Daytime fatigue, heart failure, hypertension, polycythemia, coordination loss, memory loss.

Causes

• Chronic Causes:
  • Pulmonary edema, ALS, asthma, COPD.
  • Neuromuscular disorders (e.g. MS, muscular dystrophy).
  • Obesity affecting lung expansion, pulmonary fibrosis, scoliosis.
• Acute Causes:
  • Asthma, COPD, CNS depressants (alcohol, amphetamines, opioids).
  • Emphysema, pneumonia, sleep apnea.

Diagnosis and Tests

• Diagnosis involves:

  • Symptom review and physical examination.

• Diagnostic Tests:

  • Arterial blood gas (ABG) to check CO2 and O2 levels.
  • Basic metabolic panel for chemical balance.
  • Chest X-ray for lung imaging.
  • CO2 blood test, CT scan, electrolyte panel.
  • Pulmonary function tests (PFTs).

Management and Treatment

• Underlying Conditions Treatment:

  • CPAP Machine: For sleep apnea.
  • Mechanical Ventilation: For severe cases.
  • Medications: For lung/airway conditions.
  • Oxygen Therapy: To increase blood oxygen levels.

• Medications for Acute Respiratory Acidosis:

  • Antibiotics for infections.
  • Bronchodilators, corticosteroids, diuretics.
  • Naloxone for opioid overdose.
  • Quit-smoking aids (nicotine patches, bupropion).

Prevention

• Quit smoking/tobacco use.
• Regular exercise and maintain healthy weight.
• Use CPAP machine as prescribed.
• Cautious use of sedatives, avoid mixing with alcohol.

Prognosis

• Expectations:
  • Difficult to determine outlook; based on cause and response to treatment.

Living With Respiratory Acidosis

• When to See a Provider:

  • Severe symptoms or worsening lung condition symptoms.

• Questions to Ask Providers:

  • Diagnosis confirmation and tests recommended.
  • Acute vs. chronic type.
  • Treatment options.

Common Questions

• Respiratory Acidosis vs. Respiratory Alkalosis:
  • Acidosis: CO2 retention, acidic blood.
  • Alkalosis: Excess CO2 removal, basic blood.
• Respiratory vs. Metabolic Acidosis:
  • Metabolic involves acid buildup from excessive production or insufficient kidney removal.

Cleveland Clinic Note

• Respiratory acidosis is potentially fatal, requires attention to symptoms.
• Seek medical advice for diagnosis and treatment.