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respiratory acidosis

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Lungs and bronchial tree

Alternative Names
hypercapnia

Definition
Acidosis describes a condition in which the amount of acid in the body is increased. When this condition is caused by not breathing well or fast enough, it is called respiratory acidosis.

What is going on in the body?
The kidneys and lungs work to keep the level of acid in the body at a constant level. The kidneys can get rid of acid in the urine and the lungs can get rid of acid in the form of carbon dioxide gas. Many different conditions can cause the lungs to not breathe out enough carbon dioxide.

What are the signs and symptoms of the condition?
Symptoms generally depend on the underlying cause of the respiratory acidosis. Severe acidosis from any cause may result in: What are the causes and risks of the condition?
There are many possible causes of respiratory acidosis, including:
  • lung disease, such as severe emphysema, asthma, pneumonia, or chronic bronchitis
  • blockage of the windpipe, such as from a foreign body
  • a lack of the urge to breathe, which may occur in the use of narcotics and strong sleeping pills, stroke, or other brain damage
  • weakness or paralysis of the chest muscles
  • sleep apnoea, a condition that causes people to stop breathing when they are sleeping
  • severe obesity, which makes breathing harder
What can be done to prevent the condition?
Many cases cannot be prevented. Medications, such as those for asthma, and narcotics should be taken only as prescribed. Avoidance of smoking would prevent most cases of emphysema, a common cause of respiratory acidosis. Narcotics or sleeping pills should be taken as directed. Obesity should also be avoided.

How is the condition diagnosed?
The history and physical examination usually make the doctor suspicious. An arterial blood gas test can measure the amount of acid in the blood and determine if the lungs are responsible for the acid buildup. Further tests may be needed to determine the cause, such as blood and chest x-ray tests.

What are the long-term effects of the condition?
Long term effects are often related to the cause. Respiratory acidosis, if severe, can lead to death.

What are the risks to others?
This condition is not contagious and does not pose a risk to others.

What are the treatments for the condition?
Treatment partly depends on the cause, which is treated whenever possible. Oxygen is usually given. In severe cases, a person may need to be put on a ventilator, or artificial breathing machine. If a person has a lung disease, such as asthma or emphysema, medications may be given to try and improve lung function. Obese people are advised to lose weight. Someone with sleep apnoea can use a CPAP machine to wear while during sleep.

What are the side effects of the treatments?
Those who are put on a ventilator may develop the rare complications of lung infection or damage. All medications have side effects, such as allergic reactions and stomach upset. Other side effects depend on the medications given.

What happens after treatment for the condition?
If the underlying cause is fixed, no further treatment may be needed. For instance, if a person recovers from a narcotic overdose, he or she can return to normal activities. With serious lung disease, lifelong treatment is often required.

How is the condition monitored?
Symptoms are monitored through physical examinations. Repeat blood tests to measure oxygen and acid levels in the blood are commonly done. Other monitoring, such as blood or x-ray tests, may be needed in some cases.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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