What is respiratory acidosis?

In the development of an imbalance of acids and bases in the body, a fundamental distinction is made between metabolic and respiratory disorders. The latter is based on a respiratory problem. In addition to the absorption of oxygen, respiration also causes CO2 to be expelled and thus has a considerable influence on the acid-base balance of the body.

If breathing is restricted, carbon dioxide accumulates in the blood, which leads to acidosis. Acidotic derailments can also be compensated for through respiration. This is the reason for the deep breathing that can occur in acidosis. This so-called reflectoric “kissing mouth breathing” causes an immediate increase of the pH-value in the blood by an increased exhalation of CO2.

What is lactic acidosis?

Lactate acidosis is a dreaded acute metabolic disease that can be accompanied by life-threatening consequences. It is a metabolic disorder that leads to an incorrect breakdown of glucose in energy production. In the cells of the body the glucose can be used to produce energy under oxygen consumption in order to maintain all organs and body processes.

Due to various causes, lactic acidosis can lead to a disturbance in the breakdown of glucose, whereby lactate (lactic acid) is erroneously produced as a by-product. Lactate can accumulate in the bloodstream and lead to considerable acidosis. Lactate accumulation also plays an important role in sports.

If the muscle does not produce enough energy with oxygen utilization, lactate is formed instead, which leads to rapid fatigue. Lactate, also known as “lactic acid”, primarily leads to nausea, stomach aches and the typical signs of acidosis with deep breathing. Later on, kidney weakness and a state of shock can even occur, in which various metabolic processes can lead to a lack of blood volume throughout the body, with considerable consequences on various organs.

Lactic acidosis is mainly triggered in patients with kidney or liver weakness. Typically, lactic acidosis is also found in diabetics, as the most common antidiabetic drugs can cause the disease. The agent “metformin” used for type 2 diabetes can cause lactic acidosis in rare cases.

Therapy

A suddenly occurred acidosis is an emergency situation and should therefore be treated in hospital. The therapy of acidosis differs depending on the cause. If the acidosis is caused by an acute lung disease, ventilation is often necessary.

This can improve the gas exchange in the lungs. Thereafter, the underlying disease should be treated (e.g. with antibiotics for pneumonia). If a chronic lung disease is worsening, medication that dilates the airways can often be used.

For example, “emergency sprays” (inhaled betamimetics or anticholinergics) and cortisone preparations often help. Light oxygen can be administered, but it should only be given in low doses (0.5-1 liters per minute), as there is a risk of breathing deterioration and even unconsciousness (coma). In the case of chronic lung diseases, ventilation should be chosen rather cautiously. In the therapy of metabolic acidosis, the treatment of the underlying disease is the main focus (e.g. therapy of diabetes, renal insufficiency, etc.). If the pH is very strongly shifted to below 7.10, the pH value can be raised by an infusion with the base bicarbonate.