Respiratory acidosis (patient information)

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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]

Respiratory acidosis is a condition that develops when the lungs cannot work properly to remove excess carbon dioxide from the body. This disturbs the body’s acid-base balance leading to acidic blood.

Symptoms may include:

• Confusion
• Easy fatigue
• Lethargy
• Shortness of breath
• Sleepiness

Causes of respiratory acidosis include:

• Airway diseases such as asthma and chronic obstructive lung disease, which reduce sending air into and out of the lungs
• lung tissue diseases such as pulmonary fibrosis
• Diseases of the chest such as scoliosis, which make the lungs less efficient at filling and emptying
• Diseases involving the nerves and muscles that cause the lungs to fill or empty
• Medications that suppress breathing including pain drugs, such as narcotics and sedatives such as benzodiazepines), especially concomitant use with alcohol
• Severe obesity, which limits lungs expansion

Chronic respiratory acidosis occurs over a long duration. This is a mild stable situation because the kidneys have had enough time to compensate and restore the body’s acid-base balance by rising body chemicals, such as bicarbonate.

Acute respiratory acidosis is a severe situation in which carbon dioxide levels increase very quickly and before the kidneys can restore the body to a proper acid-base balance.

Patients who are suffering from any condition listed above have the highest risk of developing respiratory acidosis.

• Arterial blood gas (measures levels of oxygen and carbon dioxide in the blood; in respiratory acidosis, the level of carbon dioxide is too high)
• Chest x-ray
• Pulmonary function test

Severe respiratory acidosis is a medical emergency. Seek immediate medical help if you have symptoms of this condition.

Call your healthcare provider if you have symptoms of lung disease.

Treatment is aimed at the underlying lung disease, and may include:

• Bronchodilator drugs to reverse some types of airway obstruction
• Noninvasive positive pressure ventilation (sometimes called CPAP or BiPAP) or mechanical ventilation if needed
• Oxygen if the blood oxygen level is low
• avoid smoking

Directions to Hospitals Treating Respiratory acidosis

• Do not smoke. Smoking leads to the development of many severe lung diseases that can cause respiratory acidosis.
• Losing weight may help prevent respiratory acidosis due to obesity (obesity hypoventilation syndrome).
• Be careful about taking sedative medications, and never combine these medications with alcohol.

How well you do depends on the disease causing the respiratory acidosis.

• Poor organ function
• Respiratory failure
• Shock
• neurologic complications such as seizure and loss of consciousness
• cardiovascular complications

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