Respiratory acidosis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Causes

Acute

• Acute respiratory acidosis occurs when an abrupt failure of ventilation occurs.
• This failure in ventilation may be caused by
  • Depression of the central respiratory center by cerebral disease or drugs,
  • Inability to ventilate adequately due to neuromuscular disease (eg, myasthenia gravis, amyotrophic lateral sclerosis, Guillain-Barré syndrome, muscular dystrophy),
  • Airway obstruction related to asthma or chronic obstructive pulmonary disease (COPD) exacerbation.

Chronic

• Chronic respiratory acidosis may be secondary to many disorders such as
  • COPD - Hypoventilation in COPD involves multiple mechanisms, including decreased responsiveness to hypoxia and hypercapnia, increased ventilation-perfusion mismatch leading to increased dead space ventilation, and decreased diaphragm function secondary to fatigue and hyperinflation.
  • Obesity hypoventilation syndrome (i.e., Pickwickian syndrome), neuromuscular disorders such as amyotrophic lateral sclerosis, and severe restrictive ventilatory defects as observed in interstitial fibrosis and thoracic deformities.
  • Lung diseases that primarily cause abnormality in alveolar gas exchange usually do not cause hypoventilation but tend to cause stimulation of ventilation and hypocapnia secondary to hypoxia. Hypercapnia only occurs if severe disease or respiratory muscle fatigue occurs.

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	Agrocide, Agronexit, Aparasin, Aphtiria, Ben-Hex, Benhexol, Benzene hexachloride, Bexol, Chloresene, Cone shell poisoning, HCH-gamma, Hexachlorocyclohexane (gamma), Lindane, Poison hemlock, Tetrodotoxin, Tick paralysis
Dermatologic	No underlying causes
Drug Side Effect	Acetylcarbromal, Alfentanil, Alprazolam, Amylobarbitone, Barbitone, Bromazepam, Brotizolam, Butabarbital, Butalbital, Butobarbitone, Camazepam, Chlordiazepoxide, Cinolazepam, Clobazam, Clonazepam, Clorazepate, Clotiazepam, Cloxazolam, Cyclobarbital, Demethyldiazepam, Diazepam, Doxefazepam, Drug overdose, Estazolam, Ethyl loflazepate, Etizolam, Etomidate, Fentanyl, Flurazepam, Fluridrazepam, Fospropofol, General anaesthesia, Halazepam, Haloxazolam, Hexobarbital, Ketazolam, Loprazolam, Lorazepam, Lormetazepam, Medazepam, Mephobarbital, Methohexital, Mexazolam, Midazolam, Nitrazepam, Oxazepam, Oxazolam, Pentobarbital, Pethidine, Phenobarbital, Pinazepam, Prazepam, Primidone, Promethazine, Propofol, Quazepam, Remifentanil, Secobarbital, Sufentanil, Tapentadol, Temazepam, Tetrazepam, Thiamylal, Thiopentone, Tofisopam, Triazolam
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	Necrotizing enterocolitis
Genetic	Athabaskan brain stem dysgenesis, Edstrom myopathy, Jeune thoracic dystrophy syndrome, Muscular dystrophy, Nemaline myopathy, Perry syndrome, Pitt-Hopkins syndrome, Ullrich congenital muscular dystrophy, X-linked myotubular myopathy, Stuve-Wiedemann syndrome
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	Clostridium tetani, Poliomyelitis
Musculoskeletal / Ortho	Cervical spine injury, Congenital diaphragmatic hernia, Congenital fiber-type disproportion myopathy, Diaphragm paralysis, Idiopathic spinal scoliosis, Rib fracture, Severe kyphoscoliosis, Stuve-Wiedemann syndrome, Muscular dystrophy, Nemaline myopathy, Ullrich congenital muscular dystrophy, X-linked myotubular myopathy, Neuromuscular diseases, Myasthenia gravis, Polymyositis
Neurologic	Amyotrophic lateral sclerosis, Brain death, Brown-Vialetto-van Laere syndrome, Central sleep apnea, CNS depression, Congenital failure of autonomic control, Guillain-Barre syndrome, Motor neuron disease, Neuromuscular diseases, Raised intracranial pressure, Subacute necrotising encephalomyelopathy, X-linked infantile spinal muscular atrophy, Athabaskan brain stem dysgenesis, Diaphragm paralysis, Brain tumor
Nutritional / Metabolic	Subacute necrotising encephalomyelopathy
Obstetric/Gynecologic	No underlying causes
Oncologic	Brain tumor
Opthalmologic	No underlying causes
Overdose / Toxicity	Acetylcarbromal, Alfentanil, Alprazolam, Amylobarbitone, Barbitone, Bromazepam, Brotizolam, Butabarbital, Butalbital, Butobarbitone, Camazepam, Chlordiazepoxide, Cinolazepam, Clobazam, Clonazepam, Clorazepate, Clotiazepam, Cloxazolam, Cyclobarbital, Demethyldiazepam, Diazepam, Doxefazepam, Drug overdose, Estazolam, Ethyl loflazepate, Etizolam, Etomidate, Fentanyl, Flurazepam, Fluridrazepam, Fospropofol, General anaesthesia, Halazepam, Haloxazolam, Hexobarbital, Ketazolam, Loprazolam, Lorazepam, Lormetazepam, Medazepam, Mephobarbital, Methohexital, Mexazolam, Midazolam, Nitrazepam, Oxazepam, Oxazolam, Pentobarbital, Pethidine, Phenobarbital, Pinazepam, Prazepam, Primidone, Promethazine, Propofol, Quazepam, Remifentanil, Secobarbital, Sufentanil, Tapentadol, Temazepam, Tetrazepam, Thiamylal, Thiopentone, Tofisopam, Triazolam, Oxygen
Psychiatric	No underlying causes
Pulmonary	Chronic bronchitis, Chronic obstructive pulmonary disease, Emphysema, Foreign body in respiratory tract, Hyaline membrane disease, Obesity hypoventilation syndrome, Obstructive sleep apnea, Pickwickian syndrome, Pneumothorax, Pulmonary hypoplasia, Respiratory depression, Respiratory distress syndrome, Severe asthma, Shallow Breathing , Snoring, Stuve-Wiedemann syndrome, Tracheal stenosis, Aspiration, Severe pneumonia
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	Myasthenia gravis, Polymyositis, Guillain-Barre syndrome
Sexual	No underlying causes
Trauma	Flail chest, Cervical spine injury, Pneumothorax, Head injury
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Asphyxiation, Reduced level of consciousness, Congenital failure of autonomic control, Shallow Breathing

Causes in Alphabetical Order

Acetylcarbromal Agrocide Agronexit Alfentanil Alprazolam Amylobarbitone Amyotrophic lateral sclerosis Aparasin Aphtiria Asphyxiation Athabaskan brain stem dysgenesis Barbitone Ben-Hex Benhexol Benzene hexachloride Bexol Brain death Bromazepam Brotizolam Brown-Vialetto-van Laere syndrome Butabarbital Butalbital Butobarbitone Camazepam Central sleep apnea Cervical spine injury Chlordiazepoxide Chloresene Chronic bronchitis Chronic obstructive pulmonary disease Cinolazepam Clobazam Clonazepam Clorazepate Clostridium tetani Clotiazepam Cloxazolam CNS depression Cone shell poisoning Congenital diaphragmatic hernia Congenital failure of autonomic control Congenital fiber-type disproportion myopathy Cyclobarbital Demethyldiazepam Diaphragm paralysis Diazepam Doxefazepam Drug overdose Edstrom myopathy Emphysema Estazolam Ethyl loflazepate Etizolam Etomidate Fentanyl Flail chest Flurazepam Fluridrazepam Foreign body in respiratory tract Fospropofol General anaesthesia Guillain-Barre syndrome Halazepam Haloxazolam HCH-gamma Hexachlorocyclohexane (gamma) Hexobarbital Hyaline membrane disease

Idiopathic spinal scoliosis Jeune thoracic dystrophy syndrome Ketazolam Lindane Loprazolam Lorazepam Lormetazepam Medazepam Mephobarbital Methohexital Mexazolam Midazolam Motor neuron disease Muscular dystrophy Myasthenia gravis Necrotizing enterocolitis Nemaline myopathy Neuromuscular diseases Nitrazepam Obesity hypoventilation syndrome Obstructive sleep apnea Oxazepam Oxazolam Oxygen Pentobarbital Perry syndrome Pethidine Phenobarbital Pickwickian syndrome Pinazepam Pitt-Hopkins syndrome Pneumothorax Poison hemlock Poliomyelitis Polymyositis Prazepam Primidone Promethazine Propofol Pulmonary hypoplasia Quazepam Raised intracranial pressure Reduced level of consciousness Remifentanil Respiratory depression Respiratory distress syndrome Rib fracture Secobarbital Severe asthma Severe kyphoscoliosis Shallow Breathing Snoring Stuve-Wiedemann syndrome Subacute necrotising encephalomyelopathy Sufentanil Tapentadol Temazepam Tetrazepam Tetrodotoxin Thiamylal Thiopentone Tick paralysis Tofisopam Tracheal stenosis Triazolam Ullrich congenital muscular dystrophy X-linked infantile spinal muscular atrophy X-linked myotubular myopathy