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## Mometrix ### Causes of respiratory acidosis include: - COPD - Overdose of sedative or barbiturate - Obesity - Severe pneumonia/atelectasis - Muscle weakness (Guillain-Barré) - Mechanical hypoventilation ### Symptoms include: - **Neuro/muscular:** Drowsiness, dizziness, headache, coma, disorient...

## Mometrix ### Causes of respiratory acidosis include: - COPD - Overdose of sedative or barbiturate - Obesity - Severe pneumonia/atelectasis - Muscle weakness (Guillain-Barré) - Mechanical hypoventilation ### Symptoms include: - **Neuro/muscular:** Drowsiness, dizziness, headache, coma, disorientation, seizures - **Cardiac:** Flushed skin, VF, decreased BP - **Gl:** absent - **Respiratory:** Hypoventilation with hypoxia ### Acute laryngotracheobronchitis Acute laryngotracheobronchitis occurs in children from 3 months to 8 years. It is a viral infection, usually caused by the human parainfluenza viruses, types 1, 2, and 3 and accounts for about 75% of the total cases. It usually follows an upper respiratory infection that slowly encompasses the larynx, resulting in swelling of the mucosa and a progressive onset of low-grade fever with characteristic "croupy" cough. Swelling can cause respiratory obstruction, resulting in acute respiratory acidosis and respiratory failure. Treatment includes: - Cool humidified air is usually best, but some respond to a warm steamy atmosphere or cool outside air. - Nebulized racemic epinephrine may be used in the hospital setting, but it is very short acting and can have a rebound effect, so children should not be treated in the ER and released. - Oral and nebulized steroids (dexamethasone, budesonide) have been shown in recent studies to provide relief, and are safe to use in the home. - Intubation and ventilation as needed. ### Acute tracheitis Acute tracheitis occurs in children from 1 month to 6 years and is usually caused by Staphylococcus aureus, with an increase in community-acquired MRSA (CA-MRSA), although Group A B-hemolytic Streptococci and H. Influenzae and other organisms are implicated. This disorder may present with symptoms similar to acute laryngotracheobronchitis, but often fails to respond to the same treatment and can result in airway obstruction and respiratory arrest, so diagnosis and treatment are critical. This condition is usually preceded by an upper respiratory infection with croupy cough and strider as well as a high fever. One difference between this and other forms of croup is the production of copious amounts of thick, purulent tracheal exudate, which are implicated in dyspnea and obstruction. Treatment includes: - Intubation and mechanical ventilation to ensure patency of airway. Tracheostomy may be necessary in some cases - Antibiotic therapy should include vancomycin if there are signs of multi-organ failure or increased incidence of CA-MRSA