Respiratory Acidosis: Causes

Pathogenesis (disease development)

In respiratory acidosis, inadequate respiration (hypoventilation) is present. As a result, too little CO2 is released from the lungs. As a result, the blood pCO2 partial pressure increases (hypercapnia) and the pH falls below 7.36. Causes of acute and chronic respiratory acidosis include:

  • Acute and chronic inhibition (inhibition) of the medullary respiratory center.
  • Acute and disease of the respiratory muscles and thoracic wall (chest wall) – e.g., muscle weakness.
  • Upper airway obstruction – e.g., foreign body aspiration (spoken when a foreign body enters the larynx (larynx), trachea (windpipe), or bronchi), laryngospasm (spasmodic constriction of the glottis), obstructive sleep apnea syndrome (OSAS)
  • Acute and chronic ventilation/perfusion disorders – e.g., pneumonia (lung infection), chronic obstructive pulmonary disease (COPD; progressive, not fully reversible obstruction (narrowing) of the airway)

Etiology (causes)

Behavioral causes

Disease-related causes

  • Amyotrophic lateral sclerosis (ALS) – progressive (progressive), irreversible degeneration of the motor nervous system.
  • Apoplexy (stroke)
  • ARDS (Adult Respiratory Distress Syndrome) – acute respiratory failure.
  • Bronchial asthma
  • Atelectasis – collapse of portions of the lungs.
  • Respiratory muscle paralysis
  • Barotrauma – condition occurring primarily in divers due to rapid changes in air pressure.
  • Obstruction of breathing such as due to rib series fractures or neuromuscular diseases.
  • Emphysema (pathological overinflation of the alveoli).
  • Guillain-Barre syndrome (GBS; synonyms: Idiopathic polyradiculoneuritis, Landry-Guillain-Barré-Strohl syndrome) – there are two courses: acute inflammatory demyelinating polyneuropathy or chronic inflammatory demyelinating polyneuropathy (disease of the peripheral nervous system); idiopathic polyneuritis (diseases of multiple nerves) of spinal nerve roots and peripheral nerves with ascending paralysis and pain; usually occurs after infections.
  • Cardiovascular arrest
  • Brainstem infarction – resulting in damage to the respiratory center.
  • Infections of the central nervous system
  • Hypokalemia (potassium deficiency), severe.
  • Kyphoscoliosis – abnormal position of the spine.
  • Laryngospasm (spasm of the glottis)
  • Pulmonary embolism – mechanical obstruction (“blockage or narrowing”) of one or more pulmonary artery branches (branches of the pulmonary artery) caused primarily by pelvic-leg thrombosis (about 90% of cases) less commonly by thrombus (blood clot) from the upper extremities
  • Pulmonary emphysema – lung disease with non-functioning alveoli.
  • Pulmonary edema – water retention in the lungs.
  • Metabolic acidosis (metabolic acidosis).
  • Multiple sclerosis (MS)
  • Muscular dystrophies – genetic muscle diseases that lead to progressive muscle wasting.
  • Muscle weakness
  • Myasthenia gravis (MG; synonyms: myasthenia gravis pseudoparalytica; MG); rare neurological autoimmune disease in which specific antibodies against the acetylcholine receptors are present, with characteristic symptoms such as abnormal load-dependent and painless muscle weakness, asymmetry, in addition to local also a temporal variability (fluctuation) in the course of hours, days or Weeks, an improvement after recovery or rest periods; clinically can be differentiated a purely ocular (“concerning the eye”), a faciopharyngeal (face (Facies) and pharynx (pharynx) concerning) emphasized and a generalized myasthenia; about 10% of cases already show a manifestation in childhood.
  • Myxedema – pasty (puffy; bloated) skin that shows a non-push-in, doughy edema (swelling) that is not positional.
  • Obstructive bronchitis – constriction of the bronchi with corresponding limitation of lung function.
  • Obstructive sleep apnea syndrome – characterized by the obstruction or complete closure of the upper airway during sleep.
  • Pickwick syndrome – combination of massive obesity, snoring andinsomnia with alveolar hypoventilation (inadequate breathing with decreased respiratory rate).
  • Pneumoconiosis (pneumoconiosis)
  • Pneumonia (pneumonia)
  • Pneumothorax (collapse of the lung caused by an accumulation of air between the visceral pleura (lung pleura) and the parietal pleura (pleura of the chest)) or hematothorax (accumulation of blood in the pleural space (airless space between the pleura of the lung and the pleura of the ribs))
  • Poliomyelitis (polio) – inflammatory disease of the spinal cord caused by inflammation.
  • Polymyositis – autoimmune disease of the skin and muscles.
  • Central sleep apnea syndrome – repeated respiratory arrests due to lack of activation of respiratory muscles (episodic inhibition of respiratory drive).

Laboratory diagnoses – laboratory parameters that are considered independent risk factors.

Medication

  • Anesthetics – drugs used to induce and induce anesthesia.
  • Opiates
  • Sedatives (tranquilizers)
  • Oxygen in chronic hypercapnia (increased carbon dioxide in the blood).

Other causes

  • Pulmonary disease and flying (here a hypoxia challenge test (HCT) is indicated to simulate the flight situation) – respiratory acidosis (hypercapnia) may develop due to the required and substituted oxygen