What is the difference between respiratory alkalosis and respiratory acidosis

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Next SlideShares. Download Now Download to read offline and view in fullscreen. One exception may be in cases of severe bronchospasm, in which bicarbonate may improve responsiveness of bronchial smooth muscle to beta-agonists.

Common causes include impaired respiratory drive eg, due to toxins, CNS disease , and airflow obstruction eg, due to asthma, COPD [chronic obstructive pulmonary disease], sleep apnea, airway edema. Treat the cause and provide adequate ventilation, using tracheal intubation or noninvasive positive pressure ventilation as needed. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.

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Good coping strategies for these types of issues are crucial. They can help lower the risk of hyperventilation and the resulting respiratory alkalosis. They can also help you function better overall in everyday life. The amount of acids and bases in your blood can be measured on a pH scale. It's important to maintain the correct balance of acids and bases. Metabolic alkalosis is a type of alkalosis that occurs when your blood becomes overly alkaline.

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An electrolyte panel including calcium, phosphate and magnesium is obtained. Kidney function tests and complete blood count CBC are also obtained.

History and physical exam are critical. Medications can provide important clues to the diagnosis. Patients also require a chest X-ray. Further pulmonary testing such as pulmonary function studies and chest computed tomography CT is determined on case-by-case basis.

This patient has chronic respiratory acidosis due to COPD. This indicates that the patient has a simple acid-base disorder chronic respiratory acidosis. His recent history is significant for nausea and vomiting.

His medication regimen includes furosemide. Initial ABGs: pH 7. This patient has acute respiratory acidosis due to myasthenia gravis crisis. Therefore, the patient has a mixed acid-base disorder, namely, acute respiratory acidosis and metabolic alkalosis. Depression of the central nervous system: infections such as encephalitis, cerebrovascular accidents, general anesthesia, alcohol, sedatives overdose, head trauma, cerebral edema.

The features of respiratory acidosis are a function of its severity and rapidity of onset. Acute respiratory acidosis can cause dyspnea, confusion, psychosis, headache, irritability and anxiety. Seizures are seen in severe cases. Chronic respiratory acidosis is asso-ciated with tremors, gait disturbances, somnolence and memory loss [7]. Hypercapnia is usually associated with hypoxemia.

Hypercapnic encepha-lopathy is due to progressive CO 2 narcosis which results in coma [3]. High CO 2 leads to vasodilation of cerebral vessels with subsequent increase in intracranial pressure [11].

In severe cases papilledema can be seen on fundoscopic examination. Severe hypercapnia can cause cardiac arrhythmias, low cardiac output and hypotension [6].

The mainstay of treatment is addressing the under-lying cause of respiratory acidosis. It is critical to know that respiratory acidosis is associated with hypoxemia and requires O 2 administration [3].

Acute and severe respiratory acidosis requires immediate action because it can be life-threatening. Some patients require endotracheal intubation and mechanical ventilation to correct acidemia and hypoxemia. Hypercapnia in patients with COPD should not be corrected aggressively.

O 2 administration is done cautiously to avoid worsening hypercapnia resulting from depression of respiratory drive. Rapid and aggressive correction may lead to seizures, cardiac arrhythmia and decreased cerebral perfusion.

Some patients develop hypercapnic coma. A reasonable goal is lowering P a CO 2 to baseline level. Some critically ill patients have mixed metabolic acidosis and respiratory acidosis and may need sodium bicarbonate NaHCO 3 infusion [1]. Alkali treatment in this setting remains an issue of controversy [12].

Low tidal volume ventilation is utilized [13]. Alkalemia causes respiratory depression via peripheral and central chemoreceptors. Frequent monitoring of ABGs and electrolytes in needed in this setting. Patients with chronic respiratory acidosis are treated with oxygen, bronchodilator, inhaled and systemic corticosteroids, and smoking cessation [1].

A pulmonary consultation is often required. Some clinicians use acetazolamide in patients with post-hypercapnic metabolic alkalosis. It should only be used by clinicians familiar with it.