Respiratory acidosis classification

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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 that occurs when the lungs are not able to remove enough of the carbon dioxide (CO2) produced by the body. Respiratory acidosis may be classified into two groups: Acute respiratory acidosis and Chronic respiratory acidosis.

Classification

Acute respiratory acidosis

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).
  • Secondary to many pathologies Chronic respiratory acidosis may occur like for eg in patients who are suffering with chronic obstructive pulmonary disease (COPD) and involve multiple mechanisams which are as follows[3][4]
    • In conditions like hypoxia and hypercapnia the responsiveness is decreased .
    • Increased in dead space ventilation due to increased ventilation-perfusion mismatch.
    • function of Diaphragm decresed due to hyperinflation and fatigue.
    • Obesity hypoventilation syndrome (OHS).[5][6]

References

  1. Epstein SK, Singh N (2001). "Respiratory acidosis". Respir Care. 46 (4): 366–83. PMID 11262556.
  2. 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.
  3. Epstein SK, Singh N (2001). "Respiratory acidosis". Respir Care. 46 (4): 366–83. PMID 11262556.
  4. 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.
  5. Brown LK (2010). "Hypoventilation syndromes". Clin. Chest Med. 31 (2): 249–70. doi:10.1016/j.ccm.2010.03.002. PMID 20488285.
  6. 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.

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