- The causes of respiratory acidosis can be divided into hypoventilation from:
- Respiratory center depression.
- Neuromuscular failure.
- Decreased respiratory system compliance.
- Increased airway resistance.
- Increased dead space.
- The symptoms of respiratory acidosis result from the pH change in the cerebrospinal fluid (CSF) and not the elevated pCO2 itself. A very severe hypercapnia may be well tolerated if it is accompanied by renal compensation and a relatively normal pH.
- Conversely, a modest rise in pCO2 can be very symptomatic if acute.
- The initial symptoms and signs may include headache and restlessness, which may progress to generalized hyperreflexia/asterixis and coma.
| || |
- Treatment is directed at correcting the underlying disorder and improving ventilation.
- Administration of NaHCO3 in order to improve the acidemia may paradoxically worsen the pH in situations of limiting ventilation. The administered HCO3 - will combine with H+ in the tissues and form pCO2 and water. If ventilation is fixed, this extra CO2 generated cannot be blown off and worsening hypercapnia will result. Therefore, HCO3 - should, in general, be avoided in pure respiratory acidoses.