Respiratory Acidosis

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Respiratory Acidosis by Mind Map: Respiratory Acidosis

1. Mechanical Airway Obstruction (ex: Tumor)

2. Airway Obstruction

2.1. Acute

2.1.1. Kidneys do not have enough time to compensate

2.1.1.1. Not a strong buffer

2.1.1.2. Acute uncompensated appearance

2.1.1.2.1. Decreased PH

2.1.1.2.2. Elevated PaC02

2.1.1.2.3. Normal/slightly elevated bicarb %

3. Acute Causes

3.1. Pleural effusion

3.2. Pneumothorax

3.3. CNS Depression

3.3.1. Drugs

3.3.2. CVA (ischemia)

3.4. Nervous System Disorders/diseases

3.4.1. MG

3.4.2. Guillian Barre

3.4.3. ALS

4. Symptoms

4.1. Rapid/shallow resperations/dyspnea

4.2. Pallor/cyanosis of skin

4.2.1. only if hypoxic

4.2.1.1. Skin may be pink secondary to vasodilation

4.3. Weakness/fatigue/malaise

4.4. Dizziness

4.5. Confusion/disorientation

4.6. Hypertension/tachycardia/arrythmias

4.7. Nausea/vomiting

4.8. Diarrhea

5. Chronic Causes

5.1. COPD

5.2. Asthma

5.3. Pleural Edema

5.4. Pleural Emboli

5.4.1. IV drug users

5.5. Pneumonia

5.6. ILD?

6. Definition: Retention of C02 (hypercapnia)

7. Pathophysiology

7.1. Decrease perfusion

7.1.1. Hypoxic injury

7.1.1.1. Anaerobic Metabolism

7.1.1.1.1. Lactic acid production

7.1.1.1.2. Decreased ATP

7.1.1.1.3. Impaired glucose delivery/use

7.1.1.2. Increase Blood Pa02

7.1.1.3. Decrease Serum pH

7.1.1.3.1. Decrease pH CSF

8. References

8.1. Akner, G., & Larsson, K. (2016). Undernutrition state in patients with chronic obstructive pulmonary disease. A critical appraisal on diagnostics and treatment. Respiratory Medicine,117, 81-91. doi:10.1016/j.rmed.2016.05.023

8.2. Bruno, C. M., & Valenti, M. (2012). Acid-base disorders in patients with chronic obstructive pulmonary disease: A pathophysiological review. Journal of Biomedicine & Biotechnology,2012, 915150-8. doi:10.1155/2012/915150

8.3. McCance, K. L. & Huether, S. E. (2014). Pathophysiology: The biologic basis for disease in  adults and children. (7th ed.). St. Louis: Mosby. ISBN 978-0-323-08854-1

8.4. Terzano, C., Di Stefano, F., Conti, V., Di Nicola, M., Paone, G., Petroianni, A., & Ricci, A. (2012). Mixed acid-base disorders, hydroelectrolyte imbalance and lactate production in hypercapnic respiratory failure: The role of noninvasive ventilation. PloS One, 7(4), e35245.

9. Chronic obstruction

9.1. Effective renal compensation

9.1.1. acidosis produced from C02

9.1.1.1. stimulates kidneys to make Bicard from H+

9.1.1.1.1. Bicarb % elevated in blood

9.1.1.1.2. PaC02 levels elevated

9.1.1.1.3. pH levels normal (compensated)

10. Outcome

10.1. If uncorrected

10.1.1. Shock

10.1.1.1. Death