What Are the Different Types of Respiratory Acidosis Treatment?

Respiratory acidosis (exhaled acid) is often caused by CO ₂ retention, and the compensation of the kidneys in the acute phase is not great, and the bicarbonate buffer system does not work. Therefore, the acidosis progresses rapidly, and it can reach severe within ten minutes. And the retained CO ₂ easily enters the cells, leading to intracellular acidosis. If not corrected in time, the mortality rate is very high. Its main features are elevated plasma PaCO ₂ and a compensatory increase in HCO ₃ ^- levels in the chronic phase.

Basic Information

Visiting department

Respiratory Medicine

Common locations

Respiratory tract

Common causes

Respiratory central inhibitors, respiratory muscle weakness, upper airway obstruction, etc.

Common symptoms

Shortness of breath, dyspnea, headache, blurred vision, irritability, etc.

Causes of respiratory acidosis

Respiratory central depressant

Such as various sedatives or narcotics.

2. Respiratory muscle or chest wall disorders

Such as respiratory muscle weakness, paralysis or restriction, insufficient ventilation or ventilation failure when using the ventilator.

3. Upper airway obstruction

Acute tracheal foreign body, acute throat spasm, etc.

4. Lung Disease

Such as chronic obstructive pulmonary disease, pulmonary edema, atelectasis, acute respiratory distress syndrome (ARDS), and so on.

5. Other

Such as high fever or hyperthyroidism.

Clinical manifestations of respiratory acidosis

Acute severe exhalation is manifested by shortness of breath, dyspnea and obvious neurological symptoms such as blurred vision of headaches, irritability, and even tremors, confusion, delirium, and coma. Physical examination can reveal optic disc edema, increased cerebrospinal fluid pressure, and arrhythmia. The symptoms of chronic exhaled acid are often masked by the primary disease.

Respiratory acidosis test

Blood gas analysis is performed, and respiratory acidosis can be diagnosed based on a decrease in pH and an increase in PCO ₂ .

Diagnosis of respiratory acidosis

According to the etiology and laboratory tests, if the plasma PaCO ₂ > 6kPa (45mmHg), consider the diagnosis of exhaled acid. In addition, the degree of compensation of HCO ₃ ^- should be judged. If PaCO ₂ rises by 1.33 kPa (10 mmHg), HCO ₃ ^- rises by 3 mmol, it is chronic exhalation; if HCO ₃ ^- rises by only 1 mmol, it is acute exhalation or mixed acid-base imbalance.

Respiratory acidosis treatment

Treatment principle

Increase alveolar ventilation as much as possible to restore diffuse function and treat the primary disease.

2. Acute respiratory acidosis

The most effective method is endotracheal intubation and mechanical ventilation. The purpose of treatment is to return the pH to normal, not to treat the abnormality of PaCO ₂ alone. If you have respiratory depression caused by drugs such as morphine, you can use naloxone intravenously.

3. Chronic respiratory acidosis

Focus on treating the primary disease. Mechanical ventilation therapy should be used conservatively.

4. Application of alkaline drugs

Sodium bicarbonate is generally unsuitable; acetazolamide (acetazamide) should be used with caution.