Respiratory acidosis hypoventilation causing

In order to effectively treat respiratory acidosis, the causative process must be identified and treated. If a cause is identified, specific therapy should be started. This may include naloxone for opiate-induced hypoventilation or bronchodilator therapy for acute bronchospasm. Because respiratory acidosis represents ventilatory failure, an increase in... 

Hypoventilation causes retention of C02 by the lungs, which can lead to a respiratory acidosis. Hyperventilation can cause a respiratory alkalosis. Metabolic acidosis can result from accumulation of metabolic acids (lactic acid or the ketone bodies p-hydroxybutyric acid and acetoacetic acid), or ingestion of acids or compounds that are metabolized to acids (methanol, ethylene glycol). Metabolic alkalosis is due to increased HC03, which is accompanied by an increased pH. Acid-base disturbances lead to compensatory responses that attempt to restore normal pH. For example, a metabolic acidosis causes hyperventilation and the release of C02, which tends to lower the pH. During metabolic acidosis, the kidneys excrete NH4+, which contains H+ buffered by ammonia. 

Respiratory distress syndrome is caused by lack of surfactant (Fig. 2) and results from failure of alveolar expansion and subsequent alveolar collapse, decreased compliance and venlilation/perfusion abnormalities. Hypoventilation produces a respiratory acidosis, and hypoxaemia leads to a metabolic acidosis. The more immature the baby, the greater is the risk of respiratory distress syndrome. 

Respiratory acidosis may be acute or chronic. Acute conditions occur within minutes or htnirs. They are uncompensated. Renal compensation has no time to develop as the mechanisms which adjust bicarbonate reabsorption take 48-72 h to become fully effective. The primary problem in acute respiratory acidosis is alveohir hypoventilation. If airflow is completely or partially reduced, the PCO, in the bltHtd will rise immediately and the H ) will rise quickly (Fig. 2). A resulting low PO, and high PCO. causes coma. If this is not reliev ed rapidly, death results. 

Respiratory acidosis is sometimes the resnlt of slow or shallow breathing (hypoventilation) caused by an overdose of narcotics or barbiturates. Anesthetists need to be particularly aware of respiratory acidosis, because most inhaled anesthetics depress respiration rates. Lung diseases, such as emphysema and pneumonia, or an object lodged in the windpipe can also result in hypoventilation. In respiratory acidosis, too little carbon dioxide is exhaled, and its concentration within the blood increases. The carbon dioxide/carbonic acid equilibrinm shifts to the left to restore the equilibrium ... 

Respiratory acidosis results when the level of CO in the blood is increased owing to hypoventilation. Slow or shallow breathing decreases the exchange of CO in the lungs and removal of this waste product from the blood. As a prime component of carbonic acid, increased CO causes a shift to the left with higher acid formation and less dissociation of the acid into component parts. 

---