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399
S. Faubel and J. Topf15 Respiratory Acidosis
15
15 Respiratory Acidosis
400
The Fluid, Electrolyte and Acid-Base Companion
Respiratory acidosis is characterized by an increased P
CO
2
and a decreasedpH. After buffering and renal compensation, the bicarbonate is increased.Increased carbon dioxide, hypercarbia, is
always
the result of inadequaterespiration.Carbon dioxide
is a waste product of cellular metabolism. Each day, thebody produces approximately 15,000 millimoles of CO
2
which needs to beeliminated by the lungs. If the lungs are unable to completely eliminatecarbon dioxide, it accumulates and causes respiratory acidosis.
The study of respiratory acidosis is the study of respiratory insufficiency.
Respiratory acidosis is characterized by an increase in ________which decreases _____. An increase in the arterial carbon dioxide level is _________ due toinadequate respiration.P
CO
2
pHalways
Introduction
Respiratory acidosis is due to respiratory in-sufficiency.
One could imagine that CO
2
levels could rise from increased production. But,
healthy
lungsare so adept at removing CO
2
, that no matter how fast CO
2
is produced, the lungs are ableto clear it. Only if lung disease is already present can increased production of CO
2
causerespiratory acidosis. For example, in patients with chronic pulmonary disease and chroni-cally elevated levels of carbon dioxide, increased metabolic production of CO
2
(e.g., sepsis)can further increase P
CO
2
.
pH
HCO
3 –
CO
2
pH
HCO
3 –
CO
2
pH
HCO
3 –
CO
2
pH
HCO
3 –
CO
2
METABOLIC
ALKALOSISRESPIRATORY
ALKALOSISRESPIRATORY
ACIDOSISMETABOLIC
ACIDOSIS
401
S. Faubel and J. Topf15 Respiratory Acidosis
Overview:
Respiration is a four-step process.
CO
2
CO
2
CO
2
O
2
O
2
O
2
O
2
O
2
O
2
To fully understand the development of respiratory acidosis, it is important tohave an understanding of respiration. Respiration is the process by which thelungs carry out their primary function of eliminating CO
2
and oxygenating theblood.Respiration occurs in four steps: 1) sensing and signaling 2) muscles andmotion 3) free flow and 4) gas exchange. Inadequate respiration causing respi-ratory acidosis may occur from a defect in one or more of the steps of respira-tion.The delivery of air to the alveoli is called
ventilation
. Ventilation encompassesthe first three steps of respiration. Hypoventilation is the inadequate deliv-ery of air to the alveoli resulting in the accumulation of carbon dioxide.
The process of respiration contains four steps: sensing and _________,muscles and motion, free _______ and gas exchange.Gas exchange occurs in the _________. Ventilation encompasses the first _______ steps of respiration.signalingflowalveolithree
Muscles and motion
The muscles of respiration expand thechest which lowers intrathoracic pressureand draws air into the lungs.
Sensing and signaling
The respiratory control center in the medullaresponds to changes in CO
2
, O
2
and pH bysending signals via nerves to the musclesof respiration.
Free flow
A patent airway is necessary for air to flowinto the alveoli.
Gas exchange
Exchange of CO
2
and O
2
occurs in the al-veoli. Oxygen enters the blood and CO
2
en-ters the alveoli.
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