Respiratory acidosis resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Khurshid.M.B.B.S

Overview


Causes

Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Diagnosis

Shown below is an algorithm summarizing the diagnosis of respiratory acidosis.

 
 
 
 
 
 
 
 
 
 
 
 
 
Suspected acid base disorder
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Acidemia
pH<7.35
 
 
 
 
 
 
 
 
Normal pH
 
 
 
 
 
 
 
 
Alkalemia
pH>7.45
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Metabolic acidosis
HCO3<24mmol/L
CO2:HCO3
12:10
 
 
 
 
 
 
Respiratory acidosis
pCO2>40mmHg
 
 
 
 
 
 
 
 
 
 
Metabolic alkylosis
HCO3>28mmol/L
CO2:HCO3
7:10
 
 
 
Respiratory alkylosis
pCO2<35mmHg
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Anion gap
 
Non anion gap
 
Acute
CO2:HCO3
10:1
 
 
Chronic
CO2:HCO3
10:3
 
 
 
 
 
 
 
 
 
 
Acute
CO2:HCO3
10:2
 
Chronic
CO2:HCO3
10:4


 
 
 
 
 
 
 
 
 
 
 
 
 
Appropriate compensation Ratio(CO2:HCO3)
Metabolic acidosis 12:10
Metabolic alkylosis 7:10
Acute respiratory acidosis 10:1
Chronic respiratory acidosis 10:3
Acute respiratory alkylosis 10:2
Chronic Respiratory alkylosis 10:4
 
 
 
 
 
 
 
 
 
 

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

 
 
 
 
 
 
 
 
 
 
 
 
 
Apnea or Respiratory distress(of recent onset)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
{{{ }}}
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Airway patency scured
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
 
 
 
 
 
 
NO
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Oxygen-rich mixture
delivered
 
 
Airway patent
 
 
Remove dentures,foreign bodies,
or food particles
Consider tracheal intubation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mental status and blood gas evaluated
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Patient alert, Blood pH>7.10 or PaCO2<80mmHg
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Patient obtunded,Blood pH<7.10 or PaCO2>80mmHg
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Administer O2 via nasal mask or prongs to maintain pO2>60mmHg
Correct reversible causes of pulmonary dysfunction with antibiotics,bronchodilators,and corticosteriods as needed
Monitor patient with abnormal arterial blood gases at 20-30 minutes of interval initially and less frequently thereafter
If PaO2 does not increase to >60mmHg or PaCO2 rises to >80mmHg,proceed to therapy for obtunded
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.

References


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