Respiratory Acidosis

IM

Respiratory Acidosis:

• Decrease PH, Increases CO2, if corrected increases HCO3
• Total peripheral resistance decrease (resistant to ionotropic med) (diltation)

Causes:

1. Upper airway obstruction by foreign body, epiglottis.
2. Sever asthma.
3. COPD, cancer, ghon,
4. Brain stem injury (inhibited Resp center in medulla).
5. Respiratory muscle: paralysis, bilateral phrenic injury.
6. Toxins causing neuromuscular junction blocking (eg.curare).
7. Anesthetic medication.
8. Morphine and heroin overdose.

i.v. dantrolene hyperth

Clinical features:

1. Somnolence; sleepy
2. Confusion
3. AMS
4. Headache
5. Palpitations
6. Papilledema
7. Brain inhibited

Treatment:

1. Fix airways obstruction (if it’s there)
2. Asthma or COPD——- bronchodilator’s
3. Treat underlying causes
4. Patient with neuromuscular injury or brain stem injury--- ventilation
5. Morphin and heparin--- naloxone
6. Barbiturates--- Dialysis
7. Benzodiazepines (gaba / enzyme inducer) + alcohol --- give flumanzil ( stimulate brain so keep patient in respiration)

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Pedia

Respiratory Acidosis

In respiratory acidosis, CO2 is not properly removed by the lungs.

Causes

• CNS depression: Comatose, drug overdose, head injury.
• Thoracic injury: Pneumothorax, flail chest.
• Airway obstruction: Asthma, laryngospasm.
• Severe pneumonia
• Pulmonary edema
• Obesity hypoventilation syndrome.
• Neuromuscular weakness: Myasthenia, Guillain-Barré syndrome.
• Interstitial fibrosis.