Respiratory acidosis classification: Difference between revisions
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==Overview== | ==Overview== | ||
[[Respiratory acidosis]] is a clinical [[condition]] | [[Respiratory acidosis]] is a clinical [[condition]] associated with [[Lung|lungs]] dysfunction in order to remove excess [[carbon dioxide]] (CO2) from the body. [[Respiratory acidosis]] may be classified into two groups: [[Acute]] [[respiratory acidosis]] and [[Chronic]] [[respiratory acidosis]]. | ||
== Classification == | == Classification == | ||
*[[Respiratory acidosis]] is classified into [[acute]] and [[chronic]] | *[[Respiratory acidosis]] is classified into [[acute]] and [[chronic]] groups, depending on the duration. | ||
===Acute respiratory acidosis=== | ===Acute respiratory acidosis=== | ||
* [[Acute]] [[respiratory acidosis]] occurs when [[PaCO2]] is increased above the upper limit of the [[References|reference]] range >45 mmHg with an accompanying [[acidemia]] (ie, pH <7.35). | * [[Acute]] [[respiratory acidosis]] occurs when [[PaCO2]] is increased above the upper limit of the [[References|reference]] range >45 mmHg with an accompanying [[acidemia]] (ie, pH <7.35). | ||
* In patients with pure [[acute]] [[respiratory acidosis]], the levels of [[hypercapnia]] and [[bicarbonate]] correctly predicts the [[pH]]. | * In patients with pure [[acute]] [[respiratory acidosis]], the levels of [[hypercapnia]] and [[bicarbonate]] correctly predicts the [[pH]]. | ||
* In contrast, | * In contrast, in patients who develop acute [[respiratory acidosis]], the measured [[pH]] will be higher than predicted. | ||
* [[Acute]] [[respiratory acidosis]] occurs due to the result of sudden failure of [[Ventilation (physiology)|ventilation]]. This failure may be due to [[central nervous system]]([[CNS]]) disease or any drug-induced [[respiratory]] [[depression]]. | * [[Acute]] [[respiratory acidosis]] occurs due to the result of sudden failure of [[Ventilation (physiology)|ventilation]]. This failure may be due to [[central nervous system]]([[CNS]]) disease or any drug-induced [[respiratory]] [[depression]]. | ||
* Inability to ventilate sufficiently , due to [[respiratory]] [[muscle]] [[paralysis]] disorders including [[myasthenia gravis]], [[amyotrophic lateral sclerosis]] [[[Amyotrophic lateral sclerosis|ALS]]], [[guillain-Barré syndrome]], [[muscular dystrophy]]. | * Inability to ventilate sufficiently , due to [[respiratory]] [[muscle]] [[paralysis]] disorders including [[myasthenia gravis]], [[amyotrophic lateral sclerosis]] [[[Amyotrophic lateral sclerosis|ALS]]], [[guillain-Barré syndrome]], [[muscular dystrophy]]. | ||
Latest revision as of 20:57, 21 September 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
Respiratory acidosis is a clinical condition associated with lungs dysfunction in order to remove excess carbon dioxide (CO2) from the body. Respiratory acidosis may be classified into two groups: Acute respiratory acidosis and Chronic respiratory acidosis.
Classification
- Respiratory acidosis is classified into acute and chronic groups, depending on the duration.
Acute respiratory acidosis
- Acute respiratory acidosis occurs when PaCO2 is increased above the upper limit of the reference range >45 mmHg with an accompanying acidemia (ie, pH <7.35).
- In patients with pure acute respiratory acidosis, the levels of hypercapnia and bicarbonate correctly predicts the pH.
- In contrast, in patients who develop acute respiratory acidosis, the measured pH will be higher than predicted.
- Acute respiratory acidosis occurs due to the result of sudden failure of ventilation. This failure may be due to central nervous system(CNS) disease or any drug-induced respiratory depression.
- Inability to ventilate sufficiently , due to respiratory muscle paralysis disorders including myasthenia gravis, amyotrophic lateral sclerosis [[[Amyotrophic lateral sclerosis|ALS]]], guillain-Barré syndrome, muscular dystrophy.
- Airway obstruction, usually seen in patients with asthma or chronic obstructive pulmonary disease (COPD).[1][2]
Chronic respiratory acidosis
- Chronic respiratory acidosis occurs when PaCO2 is elevated above the upper limit of the reference range ie >45 mmHg.
- But the pH is at the lower limit of normal or near-normal pH (eg, pH 7.33 to 7.35) secondary to renal compensation (secretion of acid from the distal tubule).
- Chronic respiratory acidosis may occur secondary to many diseases such as chronic obstructive pulmonary disease(COPD) and Obesity hypoventilation syndrome (OHS) that involve multiple mechanisms including[3][4][5][6]
- In conditions with hypoxia and hypercapnia, the responsiveness is decreased .
- Increased in dead space ventilation due to increased ventilation-perfusion mismatch.
- Function of Diaphragm decreased due to hyperinflation and fatigue.
References
- ↑ Epstein SK, Singh N (2001). "Respiratory acidosis". Respir Care. 46 (4): 366–83. PMID 11262556.
- ↑ Bruno CM, Valenti M (2012). "Acid-base disorders in patients with chronic obstructive pulmonary disease: a pathophysiological review". J. Biomed. Biotechnol. 2012: 915150. doi:10.1155/2012/915150. PMC 3303884. PMID 22500110.
- ↑ Epstein SK, Singh N (2001). "Respiratory acidosis". Respir Care. 46 (4): 366–83. PMID 11262556.
- ↑ Bruno CM, Valenti M (2012). "Acid-base disorders in patients with chronic obstructive pulmonary disease: a pathophysiological review". J. Biomed. Biotechnol. 2012: 915150. doi:10.1155/2012/915150. PMC 3303884. PMID 22500110.
- ↑ Brown LK (2010). "Hypoventilation syndromes". Clin. Chest Med. 31 (2): 249–70. doi:10.1016/j.ccm.2010.03.002. PMID 20488285.
- ↑ Berger KI, Goldring RM, Rapoport DM (2009). "Obesity hypoventilation syndrome". Semin Respir Crit Care Med. 30 (3): 253–61. doi:10.1055/s-0029-1222439. PMID 19452386.