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Respiratory Acidosis and Alkalosis 

The Respiratory System and pH

The respiratory system works with carbon dioxide to increase or decrease ventilation in order to compensate  for changes in body pH.  Carbon dioxide is part of the of the carbonic acid-bicarbonate buffering system, aiding in the regulation of body pH. (Heuther, 2017, p 125)

Respiratory Acidosis:

is the elevation of PaCO2 also known as the partial pressure of carbon dioxide, as a result of ventilation depression. (Heuther, 2017, p 128)

What does this mean? 

Normal arterial pH should be 7.35 -7.45 and normal PaCO2 is 35-45 torr. In Respiratory Acidosis, your pH falls below 7.35 and your PaCO2 is above 45 torr, thus creating an inverse relationship.  When an individual  experiences an elevated PaCO2, they are not properly ventilating. 

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Example of Respiratory Acidosis:

A patient is given too much pain medication depressing their drive to breath. This then will decrease the patients respiratory rate causing their PaCO2 to climb.  

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Interventions:

Respiratory acidosis can be corrected by increasing ventilation. 

  • Bipap (noninvasive ventilation) 

  • Endotrachel tube and Ventilator

    • Increased tidal volume:amount of air going into the lungs â€‹

    • Increase Pressure

    • Increase Respiratory Rate 

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Respiratory Alkalosis:
Alveolar hyperventilaton leading to depressed PaCO2 (Partial Pressure of carbon dioxide).(Heuther, 2017, p 127)


What does this mean?
The body is experiencing increased pH (above 7.45)and decreased PaCO2 (less than 35 torr).   Hyperventilation is the when an individual is taking many fast, deep breaths (high respiratory rate) leading to a decrease in PaCO2. 

 

Signs and Symptoms:

  • Lethargy and confusion

  • Dizziness

  • Nausea 

  • Numbness, muscle spasms

  • Tingling of extremities 

  • Tachycardia

  • Increased Respirations 

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References

Bradford, A. (2105, September 21).(Image illustrating lungs October 15, 2016).Lungs : Facts, Function and Diseases - Live Science. Retrieved from http://www.livescience.com/52250-lung.html

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DPT in NYC (2014, July 17).(Image illustrating Respiratory Alkalosis October 23, 2016).Respiratory/Metabolic Acidosis & Alkalosis ... Retrieved from http://dptinnyc.blogspot.com/2014/07/respiratorymetabolic-acidosis-alkalosis.html

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Heuther, S. E., & McCance, K. L. (2017). Fluids and Electrolytes, Acids and Bases.  In Understanding Pathophysiology. (Sixth ed., pp. 114-133). St. Louis, Missouri: Elsevier.

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McNeily, S. (2008). Respiratory Therapy Review. Dayton, OH.: RTS Publishing Company.

 

Nightingale, N. (2015, February 14). Respiratory Acidosis Study Guide. Retrieved October 14,

2016, from http://www.hellooonurse.com/2015/02/respiratory-acidosis-study-guide.html

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Parker, L. C. (2012, March). (Image illustrating ventilated patient October 23,2016). Top 10 care essentials for ventilator patients. Retrieved October 19, 2016, from https://www.americannursetoday.com/top-10-care-essentials-for-ventilator-patients/

 

Q., J. (2013, February 03). Resp/Metabolic Acidosis/Alkalosis at Lane community college –

StudyBlue. Retrieved October 14, 2016, from https://www.studyblue.com/notes/note/n/respmetabolic-acidosisalkalosis-/deck/5373412

This  tab was created on October 16, 2016 

Last edited on October 23, 2016

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