Causes of Respiratory Acidosis

Normally, respiratory acidosis occurs because of a lung disease. It can also occur by a condition
that affects typical breathing or a condition that impairs the ability of the lungs to remove carbon
dioxide. This inability results in the body fluids becoming acidic, especially the blood.
Causes of Acute Respiratory Acidosis
- Stroke – Patients that have acute strokes are not able to maintain proper ventilation to
eliminate Carbon dioxide as fast as it is produced.

- Emphysema – Emphysema is a condition that breaks down the walls between the alveoli
and leaves the lungs less able to absorb oxygen into the bloodstream and remove carbon
dioxide from the blood in an appropriate time frame.

- Pneumonia – Pneumonia causes ventilation and perfusion, also known as air flow and
blood flow, to be out of sync. This causes ‘dead space ventilation’, leaving Carbon
dioxide in the body.

- Asthma – During asthma attacks, a ventilation- perfusion mismatch occurs and results in
hypoxemia. Although compensation occurs, which lowers the PCO2 levels, if further air
trapping continues, long compliance decreases and the PCO2 levels raise.
Causes of Chronic Respiratory Acidosis
- COPD - This refers to Chronic obstructive pulmonary disease and occurs due to an
increased partial pressure of oxygen. This in turn reverses the hypoxic vasoconstriction (a
reflex contraction of the vascular smooth muscle) at the pulmonary artery level, resulting
in blood going to areas of the lungs without ventilation.

- Muscle disorders –The weakness of muscles such as the diaphragm, causes shallow
breathing, or hypoventilation. This lower’s the body’s oxygen level as Oxygen intake is
insufficient, thus increasing CO2 levels.

- Obstructive Sleep apnea-This occurs when there is an upper airway obstruction during
sleep because there is retention of carbon dioxide in the body. The airway is not
obstructed when awake. There is a decrease in PO2 (partial pressure of oxygen) and an
increase in PCO2 (partial pressure of carbon dioxide) and this leads to respiratory
acidosis.

- Severe obesity – Sever obesity reduces pulmonary vascular distensibility (percent

increase in pulmonary vessel diameter due to increase in pressure). The alveoli close up
before exhalation is complete and therefore produces a pattern of low tidal volume
 (volume of air moved into or out of the lungs) and increased respiratory rate. This causes
an increase in dead ventilation space.

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