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Respiratory acidosis is a lung disorder in which the body cannot expel enough carbon dioxide when exhaling. As a result, carbon dioxide builds up in the blood and increases its acidity. Respiratory acidosis can be an acute problem caused by drug use, an asthma attack, a chronic condition related to lung disease, or a neural disorder. Treatment measures depend on the underlying cause, but most cases can at least be temporarily relieved with oral or inhaled drugs that open the airways and allow for easier breathing.
Normal respiration regulates the amounts of oxygen and carbon dioxide in the body. Inhaled oxygen is transported from the lungs to the heart and then throughout the bloodstream. While deoxygenated, carbon dioxide-rich blood travels back to the lungs so the gas can be exhaled. Respiratory acidosis occurs when the lungs cannot sufficiently get all of the carbon dioxide out of the used blood. Metabolic processes continue to produce the same amounts of carbon dioxide, and the gas continues to build up in blood and body tissue.
Most cases of respiratory acidosis result from chronic conditions that gradually increase carbon dioxide levels. Asthma, emphysema, and bronchitis are the most common causes, but other conditions that impair the lungs such as scoliosis and muscular dystrophy may also be involved. Obesity is a major risk factor for chronic respiratory acidosis as well. Acute problems can occur with severe chest trauma, drugs that depress the central nervous system, sleep apnea, and sudden asthma attacks.
Symptoms of acute respiratory acidosis may include headaches, drowsiness, and confusion that develop over the course of minutes or hours. If the blood becomes very acidic, shock or total respiratory failure are possible. Chronic conditions generally involve a slow, progressively worsening onset of fatigue, shortness of breath and sleepiness. A person may also experience changes in mood and behavior, memory loss, insomnia, and tremors.
A lung specialist called a pulmonologist can diagnose respiratory acidosis by comparing oxygen and carbon dioxide levels in blood samples. Since acidosis is usually indicative of an underlying disorder, a pulmonologist also takes imaging scans of the chest and performs breathing tests to gauge lung capacity. Treatment decisions are made based on the severity of breathing problems and the likelihood of immediate, serious complications.
Most patients with acute or chronic respiratory acidosis find relief with bronchodilators that reduce airway constriction. If medications are responsible for acute symptoms, a patient may need to change doses or stop taking the drugs altogether. Hospitalization and oxygen therapy may be needed if breathing difficulties are severe. In order to reduce the chances of recurring or worsening acidosis, doctors encourage their patients to stop smoking, exercise regularly, and maintain healthy diets.