This book describes Respiratory Acidosis, Diagnosis and Treatment and Related Diseases
Respiratory acidosis is a disorder that happens when the lungs cannot eliminate all of the carbon dioxide the body produces.
This induces body fluids, particularly the blood, to become too acidic.
Excess CO2 induces the pH of blood and other bodily fluids to reduce, making them too acidic.
Normally, the body is able to balance the ions that regulate acidity.
This balance is gauged on a pH scale from 0 to 14.
Acidosis happens when the pH of the blood drops below 7.35 (normal blood pH is between 7.35 and 7.45).
Types of respiratory acidosis
1. Acute respiratory acidosis happens rapidly.
It is a medical emergency.
Left untreated, symptoms will become progressively worse.
It can be threatening to life.
2. Chronic respiratory acidosis forms over time.
It does not produce symptoms.
Instead, the body modifies itself to the higher acidity.
The kidneys form more bicarbonate to help keep the balance.
Chronic respiratory acidosis may not produce symptoms
Respiratory acidosis is normally caused by an underlying disease or disorder.
Some frequent causes of the acute form are:
1. Lung disorders (COPD, emphysema, asthma, pneumonia)
2. Disorders that affect the rate of breathing
3. Muscle weakness that influences breathing or taking a deep breath
4. Obstructed airways (hoking or other causes)
5. Sedative overdose
Some frequent causes of the chronic form are:
1. Asthma
2. Chronic obstructive pulmonary disease
3. Acute pulmonary edema
4. Severe obesity (disrupt expansion of the lungs)
5. Neuromuscular disorders (multiple sclerosis or muscular dystrophy)
6. Scoliosis
Symptoms
Early signs of acute respiratory acidosis are:
1. Headache
2. Anxiety
3. Blurred vision
4. Restlessness
5. Confusion
Without treatment, other symptoms may happen such as:
1. Sleepiness or fatigue
2. Lethargy
3. Delirium or confusion
4. Shortness of breath
5. Coma
The chronic form of respiratory acidosis does not normally cause any noticeable symptoms.
Diagnosis
The purpose of diagnostic tests for respiratory acidosis is:
1. To examine for any pH imbalance,
2. To determine the severity of the imbalance, and
3. To determine the disorder causing the imbalance.
Several tools can assist doctors in diagnosing respiratory acidosis.
1. Blood gas measurement
Blood gas is a series of tests used to evaluate oxygen and CO2 in the blood.
2. Electrolytes
3. Lung function tests
4. Chest X-ray and CT scan of the chest
Treatment is directed at the underlying disease, and may be:
1. Bronchodilator medicines and corticosteroids to reverse some types of airway obstruction
2. Noninvasive positive-pressure ventilation (sometimes called CPAP or BiPAP) or a breathing machine, if required
3. Oxygen if the blood oxygen level is little
4. Treatment to stop smoking
Acute form
Treating acute acidosis normally indicates managing the underlying cause.
The airway may need to be cleared as soon as possible.
Artificial ventilation may also be required.
Chronic form
If the patient has the chronic form of this disease, the treatment will focus on managing any underlying disorders.
The purpose is to improve airway function.
Some treatments are:
1. Antibiotics (to treat infection)
2. Diuretics (to reduce excess fluid affecting the heart and lungs)
3. Bronchodilators (to expand the airways)
4. Corticosteroids (to reduce inflammation)
5. Mechanical ventilation (in severe cases)
Extra-corporeal carbon dioxide removal (ECCO2 R) is a newer method for removing carbon dioxide through venovenous bypass without involving oxygenation.
ECCO2 R is being assessed for respiratory acidosis treatment

TABLE OF CONTENT
Introduction