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Respiratory acidosis
Ventilatory failure; Respiratory failure; Acidosis - respiratory
Last reviewed: August 16, 2011.
Respiratory acidosis is a condition that occurs when the lungs cannot
remove all of the carbon dioxide the body produces. This causes body
fluids, especially the blood, to become too acidic.

Causes, incidence, and risk factors

Causes of respiratory acidosis include:

Diseases of the airways (such as asthma and chronic obstructive lung

disease)

Diseases of the chest (such as sarcoidosis)

Diseases affecting the nerves and muscles that "signal" the lungs to
inflate or deflate

Drugs that suppress breathing (including powerful pain medicines,

such as narcotics, and "downers," such as benzodiazepines),
especially when combined with alcohol

Severe obesity, which restricts how much the lungs can expand

Chronic respiratory acidosis occurs over a long period of 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 is a condition in which carbon dioxide builds up
very quickly and before the kidneys can return the body to a state of
balance.

Symptoms
Symptoms may include:

Confusion

Easy fatigue

Lethargy

Shortness of breath

Sleepiness

Signs and tests

The health care provider will perform a physical exam. Tests that may be
done include:

Arterial blood gas, which measures oxygen and carbon dioxide levels
in the blood

Basic metabolic panel

Chest x-ray

Pulmonary function test

Treatment
Treatment is aimed at the underlying disease, and may include:

Bronchodilator drugs to reverse some types of airway obstruction

Noninvasive positive-pressure ventilation (sometimes called CPAP or

BiPAP) or a breathing machine, if needed

Oxygen if the blood oxygen level is low

Treatment to stop smoking

Expectations (prognosis)
How well you do depends on the disease causing the respiratory acidosis.

Complications

Poor organ function

Respiratory failure

Shock

Calling your health care provider

Severe respiratory acidosis is a medical emergency. Seek immediate
medical help if you have symptoms of this condition.
Call your health care provider if you have symptoms of lung disease.

Prevention
Do not smoke. Smoking leads to the development of many severe lung
diseases that can cause respiratory acidosis.
Losing weight may help prevent respiratory acidosis due to obesity (obesityhypoventilation syndrome).
Be careful about taking sedating medicines, and never combine these
medicines with alcohol.

References
1. Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Cecil
Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap
120.
Review Date: 8/16/2011.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine,

Division of General Medicine, Department of Medicine, University of
Washington School of Medicine. Also reviewed by David Zieve, MD,
MHA, Medical Director, A.D.A.M., Inc.

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