Respiratory acidosis is your body’s response to having too much carbon dioxide (CO2) in your lungs. The large amount of CO2 makes your body fluids and blood acidic to the point where your blood pH is below 7.35. A typical range for your blood pH is 7.35 to 7.45.
Respiratory acidosis is caused when a disease, another condition, or a physical block limits your ability to breathe. Respiratory acidosis is either chronic and asymptomatic or acute and symptomatic.
Causes
The blood becomes so acidic that the increase of carbon dioxide in your body triggers your kidneys to produce more acidic hydrogen and ammonium to absorb the bicarbonate. While the C02 might cause a disturbance to the body at first, the kidney's response to the disruption in pH creates a surplus of acid in the blood. This response is referred to medically as a “compensation”.
Depending on whether you have acute, chronic, or acute and chronic respiratory acidosis, the causes of respiratory acidosis will be different. Additionally, the severity and medical situation surrounding the respiratory acidosis will also significantly change the experience of each case.
Causes of Acute Respiratory Acidosis
Acute respiratory acidosis is defined as a sudden arrival of C02 to the lungs. Due to its sudden nature, the causes of acute respiratory acidosis are more clear-cut and perhaps, shocking. The effects of acute respiratory acidosis are so quick that the kidney’s response to it happens within minutes.
The causes include:
- Strokes or other cerebrovascular accidents
- Medications that slow down the nervous system like opioids, benzodiazepines, and pain medication
- Myasthenia gravis, which is when your voluntary muscles become weak, or you lose control of them.
- Muscular dystrophy, a group of diseases that interfere with your ability to make muscle and cause you to steadily lose your muscles.
- Guillain-Barre Syndrome, a very rare neurological disorder in which the immune system attacks itself. This can cause problems from trouble eating to full body paralysis.
- Blocked airways
- Cardiac arrest (heart attack)
Causes of Chronic Respiratory Acidosis
On the contrary, chronic respiratory acidosis is usually a symptom of a serious, underlying condition. It usually happens at a lesser degree than acute respiratory acidosis and at a slower rate. People who have chronic respiratory acidosis are often desensitized by certain features of respiratory acidosis. The most common of which would be being accustomed to a lower oxygen rate than is necessary for your tissues to be fully supplied with blood, also known as hypoxemia. They might even regard their symptoms as usual.
These conditions could be:
- Chronic obstructive pulmonary disease (COPD); a group of airflow and breathing diseases that include diseases like emphysema and chronic bronchitis
- Asthma
- Diseases that happen in the lung tissue like pulmonary fibrosis
- Muscular or nerve diseases
- Obesity
- Sleep apnea
- Thoracic skeletal defects that cause your rib cage, pecs, or sternum to be shaped in such a way that it limits your breathing or lung functioning
Symptoms
Symptoms of respiratory acidosis include:
- Hyperventilating
- Shortness of breath
- Fatigue
- Chronic exhaustion
- Headaches
- Drowsiness
- Confusion
- Sweating
- Flushed skin
- Memory loss
- Irregular sleep patterns
- Tremors
- Trouble walking
- Slower tendon reflexes
- Involuntary muscle twitching
- Papilledema, the swelling of the eye nerves due to cranial pressure
- Hypoxia, a lack of oxygen in the blood and tissues
Usually, respiratory acidosis is a symptom of another underlying condition. If untreated, this condition could cause the symptoms of respiratory acidosis to become more severe and noticeable. It can even lead to:
- Organ failure
- Shock
- Coma
- Severe damage to the kidneys
- Seizures
- Increased intracranial pressure
Depending on the severity of the respiratory acidosis, its symptoms, and its causes, it can lead to death. When there is a clear cause, it needs to be removed or otherwise dealt with.
Some of the most common forms of treatment for these underlying illnesses are:
- Medicines that help widen the bronchi
- Anti-inflammatory medications to ease any constrictive swelling
- Breathing machines like a CPAP or BiPAP
- Oxygen tubes
- Medication or other treatment to stop smoking
- Different medications
- Naloxone (for opioid overdose)
Testing for Respiratory Acidosis
If you think you have respiratory acidosis, you will need to get tested by a healthcare professional to understand how severe it is. This is especially true if you have chronic respiratory acidosis, which can be challenging to detect.
Most likely, these tests will be:
Serum Bicarbonate Testing
Possibly the most important test to get for respiratory acidosis, this test will test the level of carbon dioxide in your blood. It is a relatively non-invasive procedure that merely requires a blood sample from the arm with a needle.
Arterial Blood Glass (ABG)
These tests show the acidity as well as the balance between oxygen and carbon idioxide n your blood. This test is also done by collecting a blood sample with a needle.
In addition to these tests, your healthcare provider might want to do other tests related to your muscles, kidneys, sleep, or breathing. It all depends on your unique medical situation and the cause or possible cause of your respiratory acidosis.
Prevention
The best way to prevent getting respiratory acidosis is simply to quit smoking or not to start smoking. Being overweight or obese also dramatically increases your chances of getting respiratory acidosis. Losing weight would help you to avoid getting it.
Additionally, if you are prescribed strong pain medications or opioids, it is imperative that you do not drink alcohol when you take these medications.