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    Respiratory acidosis

    Ventilatory failure; Respiratory failure; Acidosis - respiratory

    Respiratory 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:

    • Airway diseases, such as asthma and chronic obstructive pulmonary disease (COPD)
    • 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 can cause respiratory acidosis while you are asleep

    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:

    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)
    • Oxygen if your blood oxygen level is low
    • Treatment to stop smoking.
    • 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
    • Shock

    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.

    Open References

    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, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 104.

      • Respiratory system

        Respiratory system - illustration

        Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

        Respiratory system

        illustration

        • Respiratory system

          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: 8/19/2024

        Reviewed By: Allen J. Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant Professor, Rutgers New Jersey Medical School, East Orange, NJ. Review provided by VeriMed Healthcare Network. 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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