Respiratory Acidosis Overview

Questions and Answers

What is respiratory acidosis?

Respiratory acidosis is a clinical disorder in which the pH is less than 7.35 and the PaCO2 is greater than 45 mm Hg.

Briefly explain the pathophysiology of respiratory acidosis.

It occurs due to inadequate excretion of CO2, leading to elevated plasma CO2 concentrations and increased levels of carbonic acid, along with decreased PaO2.

In what type of conditions does respiratory acidosis occur?

It occurs in situations like acute pulmonary edema, aspiration of foreign objects, atelectasis, and severe COPD, among others.

List some clinical manifestations of respiratory acidosis.

Increased pulse, blood pressure, respiratory rate, confusion, disorientation, or diminished level of consciousness. Signup and view all the answers

What symptoms can an elevated PaCO2 greater than 60 mmHg cause?

Reflexive cerebrovascular vasodilation and increased cerebral blood flow. Signup and view all the answers

What heart rhythm may be the first sign of respiratory acidosis in anesthetized patients?

Ventricular fibrillation. Signup and view all the answers

What can begin to occur if respiratory acidosis is severe?

Increased intracranial pressure, resulting in papilledema and dilated conjunctival blood vessels. Signup and view all the answers

How does respiratory acidosis affect potassium and hydrogen ion concentration?

It causes hyperkalemia as hydrogen ions move into cells, resulting in a shift of potassium out of the cell. Signup and view all the answers

What diseases can cause chronic respiratory acidosis?

Chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis, obstructive sleep apnea, and obesity. Signup and view all the answers

Why is oxygen used very cautiously in patients with long-term COPD?

Because high oxygen concentration can remove the stimulus of hypoxemia, leading to respiratory failure. Signup and view all the answers

Explain the ABG of respiratory acidosis.

ABG analysis shows a pH less than 7.35, a PaCO2 greater than 45 mm Hg, and variable bicarbonate levels. Signup and view all the answers

What is the treatment for respiratory acidosis?

Treatment focuses on improving ventilation in acute and chronic respiratory acidosis. Signup and view all the answers

How are bronchodilators used to treat respiratory acidosis?

Bronchodilators reduce bronchial spasm and increase ventilation. Signup and view all the answers

Study Notes

Respiratory Acidosis

Characterized by pH < 7.35 and PaCO2 > 45 mm Hg; can be acute or chronic.

Pathophysiology

Caused by inadequate CO2 excretion due to poor ventilation, leading to elevated CO2 and carbonic acid levels.
Elevated PaCO2 typically results in decreased PaO2.

Conditions Causing Respiratory Acidosis

Acute: pulmonary edema, foreign body aspiration, atelectasis, pneumothorax, sedative overdose.
Non-emergent: sleep apnea with obesity, severe pneumonia, acute respiratory distress syndrome.
Common in patients with severe COPD, especially during respiratory infections or heart failure.
Associated with diseases impairing respiratory muscles (e.g., scoliosis, muscular dystrophy, multiple sclerosis).

Clinical Manifestations

Symptoms include tachycardia, increased blood pressure, elevated respiratory rate, confusion, disorientation, and decreased consciousness levels.

Effects of Elevated PaCO2

PaCO2 > 60 mm Hg leads to cerebrovascular vasodilation and increased cerebral blood flow.

Anesthetic Considerations

Ventricular fibrillation may be the initial sign of respiratory acidosis in anesthetized patients.

Severe Respiratory Acidosis

Increased intracranial pressure may occur, leading to papilledema and dilated conjunctival blood vessels.

Potassium and Hydrogen Ion Concentration

Acidosis results in hyperkalemia as hydrogen ions shift into cells, causing potassium to move into the bloodstream.

Chronic Respiratory Acidosis

Associated with diseases like COPD (emphysema, chronic bronchitis), obstructive sleep apnea, and obesity.
Symptoms may not develop unless PaCO2 rises quickly; prolonged conditions allow the body to adapt.

Oxygen Use in Long-term COPD

Caution is necessary as chronic hypercapnia may desensitize the respiratory center to CO2, relying on hypoxic drive to breathe.
High oxygen concentrations can eliminate hypoxic stimulus, risking respiratory failure.

Arterial Blood Gas (ABG) Analysis

ABG in respiratory acidosis shows pH < 7.35, PaCO2 > 45 mm Hg; bicarbonate levels vary by condition duration.

Treatment Approaches

Focus on enhancing ventilation for acute and chronic respiratory acidosis.
Treatment specifics vary based on the cause of inadequate ventilation.

Role of Bronchodilators

Bronchodilators are utilized to reduce bronchial spasms and improve ventilation.

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Description

This quiz covers the characteristics, causes, and clinical manifestations of respiratory acidosis, including acute and chronic conditions. It also discusses the impact of elevated PaCO2 levels and associated diseases. Test your understanding of this important respiratory condition.