Respiratory acidosis

The manifestations of acute severe metabolic acidemia (pH less than 7.15 to 7.20) involve the cardiovascular, respiratory, and central nervous systems. Hyperventilation is often the first sign of metabolic acidosis. Respiratory compensation may occur as Kussmaul s respirations (i.e., deep, rapid respirations characteristic of diabetic ketoacidosis). 

Noninvasive positive-pressure ventilation (NPPV) provides ventilatory support with oxygen and pressurized airflow using a face or nasal mask with a tight seal but without endotracheal intubation. In patients with acute respiratory failure due to COPD exacerbations, NPPV was associated with lower mortality, lower intubation rates, shorter hospital stays, and greater improvements in serum pH in 1 hour compared with usual care. Use of NPPV reduces the complications that often arise with invasive mechanical ventilation. NPPV is not appropriate for patients with altered mental status, severe acidosis, respiratory arrest, or cardiovascular instability. 

Lactic acidosis, respiratory dysfunction, uncompensated metabolic alkalosis, hypocalcemia, hypokalemia, hypercapnia... 

Acute toxicity manifests primarily in the CNS, cardiovascular system, and gastrointestinal system. CNS signs include restlessness, tremor, nervousness, headache, insomnia, tinnitus, confusion, delirium, psychosis, and seizures. Cardiac manifestations of overdose include sinus tachycardia, various dysrhythmias, asystole, and cardiovascular collapse. Other findings include tachypnea, nausea, vomiting, hematemesis, diarrhea, and fever. Case reports also include rhabdomyolysis and pulmonary edema. Laboratory findings include metabolic acidosis, respiratory alkalosis, ketosis, hypokalemia, and hyperglycemia. The estimated lethal dose in adults is 150-200 mg kg whereas doses of 10-15mgkg ... 

Oral or intravenous administration Phosphate-containing laxatives or enemas Increased extracellular phosphate load Transcellular shift Lactic acidosis Respiratory acidosis Untreated diabetic ketoacidosis Cell lysis... 

These disorders are classified according to their cause and the direction of the pH change into respiratory acidosis, metabolic acidosis, respiratory alkalosis, or metabolic alkalosis. Any derangement of acid-base balance elicits... 

Not appropriate for patients with altered mental status, severe acidosis, respiratory arrest, or cardiovascular instability. 

The toxicity spectrum of aspirin does not include (A) Increased risk of encephalopathy in children with viral infections Increased risk of peptic ulcers Hyperprothrombinemia Metabolic acidosis Respiratory alkalosis... 

Hyperosmolar hyperglycaemia (HH) is generally the fulminant result of poorly treated type 2 diabetes or delayed diagnosis of previously unknown type 2 diabetes. HH is less frequent than DKA, but mortality is higher and remains close to 15% in many centres [1,20]. As implied hyperosmolality is the primary clinical problem and there will be hyperglycaemia of >35 0 mmol/L and an effective seram osmolality of >320 mOsm/kg (Table 1). HH most often occurs in frail patients in combination with other potentially fatal conditions. Strict differentiation between DKA and HH can be difficult, because some degree of ketosis may be present in HH and because, for example, lactic acidosis, respiratory and renal failure may also be present. In practise this dilemma is mainly ornamental, since diagnostic and therapeutic efforts follow the same principles. 

OAcanpresenteitherasasevereneonatal-onset form (poor feeding, vomiting, lethargy, tachypnea, progressing to acidosis, respiratory distress, coma, death) or late-onset form (usually recurrent ketoacidosis or lethargy with catabolic stress). 

Hypercarbia, i.e., elevated carbon dioxide levels, will result in a respiratory acidosis. Respiratory rate may be increased in an attempt to remove carbon dioxide, but blocked airways may make efforts ineffective. Electrolyte shifts to balance acidosis may result. 

Respiratory Centers Receptors Chemoreceptors Pulmonary Acidosis Respiratory Alkalosis... 

Fluid and electrolyte dehydration, hyperkalemia, metabolic acidosis, respiratory alkalosis... 

Within minutes, Brianna determines that the patient s blood pH is 7.30 and the partial pressure of CO2 gas is above the desired level. Blood pH is typically in the range of 7.35-7.45, and a value less than 7.35 indicates a state of acidosis. Respiratory acidosis occurs due to an increase in the partial pressure of CO2 gas in the bloodstream which prevents the biochemical buffers in blood from making a change in the pH. 

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