Respiratory acidosis occurs when improper lung function causes carbon dioxide to build up in the body. Anything that impairs lung function can cause this secondary condition, and these issues range in severity. In many cases, the body can compensate for respiratory acidosis for a period, which can delay recognition and diagnosis. Eventually, the system will be overwhelmed, and the condition can lead to serious complications.
Acidosis develops when too much carbon dioxide collects in the blood. Various issues can cause this, but if improper working of the lungs is to blame, doctors will diagnose it as respiratory acidosis. The lungs have two main jobs: diffuse oxygen into the blood and expel carbon dioxide. When they cannot accomplish the latter, CO2 accumulates in the body, notably in the blood. Carbon dioxide is acidic; too much of it raises the blood's pH, which can have many negative effects.
Anything that interferes with lung function can lead to respiratory acidosis, including diseases of the airway, such as COPD and asthma, and diseases that damage the lung tissue itself, like pulmonary fibrosis or emphysema. Scoliosis, obesity, and injuries that prevent the lungs from fully expanding can also cause the condition, as can medications that suppress breathing.
For a while after the issue develops, the body can compensate for respiratory acidosis and maintain a normal pH in the blood. Specifically, the kidneys begin to produce bicarbonate, which counteracts the falling pH and brings it back to neutral. If the respiratory problem is severe enough or if respiratory acidosis comes on quickly, the kidneys can no longer keep up, and the pH imbalance progresses.
Signs of respiratory acidosis include neurological symptoms such as confusion, anxiety, lethargy, and sleepiness. Someone with respiratory acidosis often experiences shortness of breath. He or she may breathe rapidly, the body's way of attempting to get rid of the excess carbon dioxide. Other signs include sweating, flushed skin, and tremors.
Doctors begin the diagnostic process with a physical exam, during which the doctor will listen to lung sounds and evaluate the patient's breathing. Several tests can confirm respiratory acidosis. The most common is an arterial blood gas: blood is drawn directly from the artery and tested for oxygen and carbon dioxide levels. A pulmonary function test will give the doctor a more accurate understanding of a patient's lung function. Chest x-rays and CT scans help determine the underlying cause.
Treatment ultimately depends on the underlying issue. A doctor may treat airway problems with corticosteroids or bronchodilators. People with sleep apnea may require a CPAP or BiPAP machine during the night. Smoking cessation is essential. If respiratory acidosis becomes severe, the individual may require oxygen and mechanical ventilation.
If left untreated or uncorrected, complications of respiratory acidosis can be severe. People can experience significant organ damage and complete respiratory failure, both of which usually require extended hospital admission, likely in an intensive care unit. When interventions are ineffective, the person can go into shock, which is life-threatening.
The outlook depends on a few factors, chief among them how quickly a doctor can diagnose respiratory acidosis. Again, this can be tricky because the body compensates for increased carbon dioxide to a certain extent. Additionally, respiratory acidosis does not just happen. The underlying conditions that cause it range in severity and affect the prognosis.
Anyone with signs of severe respiratory acidosis should seek emergency care. It can be difficult to get the condition under control at a certain point so early interventions can be life-saving. People already diagnosed with chronic lung disease must pay attention to any changes in lung function. If sudden changes occur, contact a physician right away.
Prevention depends on the underlying cause, to a certain degree. If a person has sleep apnea, they should make sure to wear their CPAP or BiPAP at night. For people who experience problems due to obesity, weight loss can help. Anyone at risk for respiratory acidosis should be careful when taking sedatives and never combine them with alcohol. Finally, avoid or stop smoking to significantly lower the risk of respiratory conditions.
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