Respiratory acidosis

When the lungs are unable to sufficiently expel the carbon dioxide (CO2) that now the body produces, respiratory acidosis results. The pH of human blood and other body fluids decreases as a result of too much CO2, making them overly acidic.

Normally, the ions that regulate acidity may be balanced by the body. On a pH ranging from zero to 14, doctors evaluate this equilibrium. When the blood pH drops below 7.35, acidosis sets in. A healthy blood pH range is between 7.35 and 7.45.

The most common cause of respiratory acidosis is an underlying illness or condition. Failure of the respiratory or ventilatory systems is another name for this.

The lungs normally inhale oxygen and release CO2. The lungs release oxygen into the blood, while CO2 exits the other way to be expelled as waste. But occasionally, the lungs are unable to sufficiently expel CO2. This could be brought on by a reduction in breathing or airflow brought on by an underlying ailment like:

  • asthma
  • persistent pulmonary obstruction (COPD)
  • pneumonia
  • nap apnea

We examine the many forms of respiratory acidosis, the signs and symptoms they produce, and the circumstances that may contribute to their occurrence.

Respiratory acidosis types

Acute and chronic respiratory acidosis are the two different forms.

respiratory acidosis that is acute

This happens when your body’s ability to expel CO2 declines following a fast rise in CO2 levels. This kind manifests suddenly and is a medical emergency. If left untreated, symptoms will worsen over time and may even become life threatening.


respiratory acidosis that persists

Your brain receives alerts from certain chemoreceptors when CO2 levels are raised, and these chemoreceptors also regulate your body’s ventilation, and how it expels waste gasses from your blood. Chronic respiratory acidosis results from these receptors losing their sensitivity, which makes them less likely to detect high levels.

This kind doesn’t create symptoms and grows gradually. Your body instead adjusts to the increased amount. To keep your acid balance, for instance, the kidneys make more bicarbonate.

It’s possible that chronic respiratory acidosis goes unnoticed.

Reproductive acidosis, both acute and chronic

Some individuals experience persistent respiratory acidosis and a co-occurring condition that has an impact on breathing. Even if you have never before noticed symptoms, this might make your chronic presentations worse.

respiratory acidosis symptoms

Acute respiratory acidosis’s early warning signals include

dependable source

  • breathlessness
  • headache
  • wheezing, fear, and visional haze
  • restlessness
  • the hands and feet have a blue hue (if oxygen levels are also low)

Other symptoms might manifest in persons with severe respiratory acidosis or without therapy. These consist of:

  • drowsiness or exhaustion
  • lethargy
  • Disorientation or delirium
  • twitching and involuntary muscle motions
  • potential convulsions
  • character alters
  • coma

Usually, the chronic type of respiratory acidosis has no apparent symptoms. When they appear, symptoms might include:

  • loss of memory
  • coordination difficulties
  • Increasing the body’s red blood cell circulation is also referred to as
  • polycythemia
  • the condition is characterized as excessive blood arterial pressure around the lungs
  • Thoracic hypertension
  • heart disease
  • Obstructive sleep apnea is associated with fatigue and headaches (OSA)

Commonly occurring respiratory acidosis causes

The two main organs that play a role in controlling the pH of your blood are the lungs and kidneys. Acid is eliminated by the kidneys through urine and the lungs by inhaling CO2. The kidneys also control the amount of bicarbonate in your blood (a base, which is on the other end of the spectrum from an acid).

The most common cause of respiratory acidosis is a lung problem or illness that interferes with normal breathing or the lungs’ capacity to expel CO2.

Acute respiratory acidosis causes

The following are some typical acute form causes:

  • COPD
  • emphysema
  • asthma
  • pneumonia
  • circumstances that influence your breathing rate
  • muscular weakness that makes it difficult to breathe deeply or breathe fully
  • narrowed airspace (due to choking or other causes)
  • excessive usage of substances like opioids that have central nervous system effects

Chronic respiratory acidosis causes

The following frequently result in persistent respiratory acidosis:

  • asthma
  • COPD
  • acute lung edema
  • extreme obesity that prevents the lungs from expanding
  • diseases of the neuromuscular system (including muscular dystrophy, Guillain-Barré syndrome, and multiple sclerosis)
  • scoliosis
  • Acute lateral sclerosis (ALS)

Respiratory acidosis diagnosis

The following are the objectives of diagnostic testing for respiratory acidosis:

  • in order to detect any pH imbalance
  • to assess how serious the mismatch is
  • to determine the issue that’s producing the imbalance

Doctors can detect respiratory acidosis using a variety of methods.

Blood gas analysis

Measurement of oxygen and CO2 levels in the blood is done using a series of procedures called blood gas.

Your artery will be sampled for blood by a medical expert. High CO2 levels may be an acidosis indicator.


The term “electrolyte testing” refers to a collection of tests that gauge your body’s levels of various minerals and salts, including:

  • sodium
  • potassium
  • chloride
  • bicarbonate

People who suffer from respiratory acidosis or other acid-base disorders will either have one or more electrolytes greater or lower than normal.

Tests of lung function

Lung function is compromised in many persons with this illness. When your lungs are doing the following tasks, a number of tests can be used to assess their effectiveness:

  • airflow into and out of the lungs
  • the process of putting oxygen in your blood
  • keeping sufficient air

These tests consist of:

  • Spirometry. You will be instructed to inhale and exhale through a spirometer by a medical practitioner. This gauges the volume of air you breathe in and out as well as the volume of air you move while doing it.
  • Test of lung volume. You’ll inhale deeply and exhale slowly while sitting in an airtight booth. The air pressure in your lungs will change depending on how much air you breathe in, making it possible for a medical specialist to calculate how much air their lungs can contain.
  • test for gas diffusion You’ll use a mouthpiece connected to a device to inhale a safe rate of carbon monoxide. Your doctor may be able to determine from this how well your lungs are working to transfer gasses into the circulation.
  • exercising test. This is riding an exercise bike or treadmill while jogging while having your blood pressure, heart rate, and blood oxygen levels monitored. The activity demonstrates how your lungs respond to physical exertion.

A chest X-ray

X-rays can assist doctors in identifying injuries, muscle disorders, or skeletal abnormalities that may contribute to acidosis.

other tests

Your doctor may order further tests to assist identify the illness that’s causing the acidosis based on the results of these tests.

Similar symptoms might also be brought on by a different illness called metabolic acidosis. To ensure that the issue is limited to respiratory issues, the doctor may prescribe testing. These tests examine your body’s level of acid, which can be brought on by renal disease, diabetes, or other illnesses. They look at things like glucose, lactate, and ketosis.

Other testing consist of:

  • a drug test
  • a whole blood count (CBC)
  • urinalysis (urine test)

respiratory acidosis treatment

There are several ways to treat respiratory acidosis.

acute respiratory acidosis treatment

The underlying cause must typically be treated in order to treat acute respiratory acidosis. As severe respiration is a medical problem, you should get help right away.

For instance, your doctor might have to administer treatments that open up your airway, including bronchodilator drugs.

A device like BiPAP, which helps with respiratory and gas exchange without any need for intrusive tubing, may also be necessary for artificial ventilation.

Chronic respiratory acidosis treatment

In order to prevent an acute manifestation of the illness, your healthcare provider will concentrate on controlling any underlying issues if you do have chronic respiratory acidosis.

  • To enhance airway function is the aim. Among the drugs used to treat respiratory acidosis are:
  • to treat infection, use antibiotics
  • diuretics, to lessen the accumulation of extra fluid in the lungs and heart
  • the use of bronchodilators to widen the airways
  • steroids, which decrease inflammation
  • mechanical ventilation to help those with severe respiratory conditions breathe acidosis


Since respiratory acidosis involves a diverse range of underlying causes, it is challenging to make generalizations regarding its prognosis.

Your prognosis mostly depends on what’s causing your illness, and after assessing your physical effects and running tests, your doctor must be able to tell you what to anticipate.

When should someone with severe respiratory acidosis seek emergency care?

Respiratory acidosis that is acute might be lethal. If any of the following apply to you:

  • suddenly find it difficult to breathe
  • you have a blockage in your airway

If you already suffer chronic respiratory acidosis or any one of the other lung illnesses, this is very crucial.

The best way to avoid respiratory acidosis

Avoiding probable causes of acidosis is the most effective strategy to stop the condition.

Avoid smoking

Making the decision to give up smoking might be beneficial. Smokers are more susceptible to developing persistent respiratory acidosis. Smoking is detrimental to lung health. It can negatively affect everyone’s quality of life and increase the risk of respiratory illnesses.

Control your weighs

Obesity hypoventilation syndrome (OHS), commonly referred to as Pickwickian syndrome, can occur in some obese persons and serve as a root cause of respiratory acidosis.

When using sedatives, use care.

They could make it difficult for you to breathe. The nervous system is suppressed by sedatives, and its nervous system plays a big part in breathing mechanics. The following actions can assist you in safeguarding your respiratory health when using sedatives:

  • Always read the label and abide by it.
  • Never exceed the recommended dosage.
  • Sedatives and alcohol shouldn’t be combined since doing so can be deadly.

Some diseases of respiratory acidosis, including MS, cannot be prevented. However, the aforementioned actions could assist you in lowering your danger of a serious emergency.

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