Respiratory acidosis
Ventilatory failure; Respiratory failure; Acidosis - respiratoryRespiratory acidosis is a condition that occurs when your lungs can’t remove all of the carbon dioxide produced by your body. This causes the blood and other body fluids to become too acidic.
Causes
There are many causes of respiratory acidosis, including:
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Airway diseases, such as asthma and COPD
Asthma
Asthma is a chronic disease that causes the airways of the lungs to swell and narrow. It leads to breathing difficulty such as wheezing, shortness o...
ImageRead Article Now Book Mark ArticleCOPD
Chronic obstructive pulmonary disease (COPD) is a common lung disease. Having COPD makes it hard to breathe. There are two main forms of COPD:Chroni...
ImageRead Article Now Book Mark Article - Lung tissue diseases, such as pulmonary fibrosis, which causes scarring and thickening of the lungs
Pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF) is scarring or thickening of the lungs without a known cause.
ImageRead Article Now Book Mark Article - Diseases that can affect the chest, such as scoliosis
- Diseases that affect the nerves and muscles that signal the lungs to inflate or deflate
- Medicines that suppress breathing, including narcotics (opioids), and "downers," such as benzodiazepines, often when combined with each other or alcohol
- Severe obesity, which restricts how much the lungs can expand
- Obstructive sleep apnea
Chronic respiratory acidosis occurs over a long time. This leads to a stable situation, because the kidneys increase body chemicals, such as bicarbonate, that help restore the body's acid-base balance.
Acute respiratory acidosis occurs when carbon dioxide builds up very quickly, before the kidneys can return the body to a state of balance.
Some people with chronic respiratory acidosis get acute respiratory acidosis when a serious illness worsens their condition and disrupts their body's acid-base balance.
Symptoms
Symptoms may include:
- Confusion
- Anxiety
- Easy fatigue
- Lethargy
- Shortness of breath
- Sleepiness
- Tremors (shaking)
- Warm and flushed skin
- Sweating
Exams and Tests
Your health care provider will perform a physical exam and ask about symptoms.
You may have certain tests, including:
- Arterial blood gas (measures oxygen and carbon dioxide levels in the blood)
Blood gas
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
ImageRead Article Now Book Mark Article - Basic metabolic panel
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
ImageRead Article Now Book Mark Article - CT scan of the chest
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Pulmonary function test to measure breathing and how well the lungs are functioning
Pulmonary function test
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
ImageRead Article Now Book Mark Article - Ultrasound of the heart (echocardiogram)
Treatment
Treatment is aimed at the underlying disease, and may include:
- Bronchodilator medicines and corticosteroids to reverse some types of airway obstruction
- Noninvasive positive-pressure ventilation (called CPAP or BiPAP)
CPAP
Positive airway pressure (PAP) treatment uses a machine to pump air under pressure into the airway of the lungs. This helps keep the windpipe open d...
ImageRead Article Now Book Mark Article - Oxygen if your blood oxygen level is low
- Treatment to stop smoking.
Stop smoking
There are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...
ImageRead Article Now Book Mark Article - Changing medicines when appropriate
If your case is severe, you may need to be put on a breathing machine (ventilator).
Outlook (Prognosis)
How well you do depends on the disease causing the respiratory acidosis.
Possible Complications
Complications may include:
- Poor organ function
- Respiratory failure
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Shock
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...
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When to Contact a Medical Professional
Severe acute respiratory acidosis is a medical emergency. Seek medical help right away if you have symptoms of this condition.
Call your provider if you have symptoms of lung disease that suddenly get worse.
Prevention
DO NOT smoke. Smoking can lead to many severe lung diseases that can cause respiratory acidosis.
Losing weight may help prevent respiratory acidosis due to obesity (obesity-hypoventilation syndrome).
Be careful about taking sedating medicines, and never combine these medicines with alcohol.
Use your CPAP device regularly if it has been prescribed for you.
References
McCoin NS, Self WH. Acid-base disorders. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 113.
Sanghavi S, Albert TJ, Swenson ER. Acid-base balance. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 12.
Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 110.
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Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
Review Date: 7/31/2022
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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