Acidosis describes an imbalance of chemistry in the body in which the amount of acid in the body fluids and cells compared to the amount of alkali (base) is increased. When this condition is caused by not breathing well or fast enough, it is called respiratory acidosis.
The kidneys and lungs work together to keep the level of acid and base in the body in a delicate balance. The kidneys can get rid of acid in the urine and the lungs can get rid of acid in the form of carbon dioxide gas. Many different conditions can cause the lungs not to breathe out enough carbon dioxide.
Symptoms generally depend on the underlying cause of the respiratory acidosis. Severe acidosis from any cause may result in: shortness of breathanxietyconfusion or memory losspsychosis or hallucinationspersonality changesheadachesdrowsiness or fatiguetremorsif not corrected, loss of consciousness, coma, or even death
There are many possible causes of respiratory acidosis, including: lung disease, such as severe emphysema, asthma, pneumonia, or chronic bronchitisblockage of the windpipe, such as from a foreign bodya lack of the urge to breathe, which may occur in the use of narcotics and strong sleeping pills, stroke, or other brain damageweakness or paralysis of the chest musclessleep apnea, a condition that causes people to stop breathing when they are sleepingsevere obesity, which makes breathing harder
Many cases cannot be prevented. Medications, such as those for asthma, and narcotics should be taken only as prescribed. Avoidance of smoking would prevent most cases of emphysema, a common cause of respiratory acidosis. Narcotics or sleeping pills should be taken as directed. Obesity should also be avoided.
The healthcare professional may suspect respiratory acidosis from the history and physical exam. The diagnosis is made using an arterial blood gas test. This test measures the balance of acid and base in the blood and determines if the lungs are responsible for the acid buildup. Further blood tests or x-rays may be needed to determine the underlying cause.
Long term effects are often related to the cause. Respiratory acidosis, if severe, can lead to death.
This condition is not contagious and does not pose a risk to others.
Treatment partly depends on the cause, which is treated whenever possible. Oxygen is usually given. In severe cases, a person may need to be put on a ventilator, or artificial breathing machine. If a person has a lung disease, such as asthma or emphysema, medications may be given to try and improve lung function.
Obese people are advised to lose weight. Someone with sleep apnea can use a machine known as a continuous positive airway pressure (CPAP) device to keep the airway open during sleep
Those who are put on a ventilator may develop the rare complications of lung infection or damage. Each medication has its own list of possible side effects, of which allergic reactions and stomach upset are two of the more common.
If the underlying cause is fixed, no further treatment may be needed. For instance, if a person recovers from a narcotic overdose, he or she can return to normal activities. With serious lung disease, lifelong treatment is often required.
Respiratory acidosis is monitored by serial arterial blood gas measurements. If an individual is critically ill and needs to have blood gas measured repeatedly for several hours or days, an arterial line can be inserted - usually in an intensive care unit - to remove the need for repeated arterial punctures. Other blood tests or x-rays may be needed in some cases.
Harrison's Principles of Internal Medicine, 1998, Fauci et al.
Cecil Textbook of Medicine, 1996, Bennett et al.
