Anatomy & Physiology

Respiratory acidosis is a condition that occurs when the lungs cannot remove all the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic. Chronic respiratory acidosis occurs over a long period of time, this leads to a stable situation, because the kidneys increase body chemicals, such as bicarbonate, that help restore the body’s acid-base balance. Acute respiratory acidosis is a condition in which carbon dioxide builds up quickly, before the kidneys can return the body to a state of balance. Some of the symptoms may include: confusion, fatigue, lethargy, shortness of breath, and sleepiness. Some causes of respiratory acidosis are: diseases of the airways, such as asthma; diseases of the chest, such as scoliosis; drugs that suppress breathing, such as narcotics and downers; and severe obesity, which restricts how much the lungs can expand. Treatment may include: bronchodilator drugs to reverse some types of airway obstruction; a breathing machine such as CPAP or BiPAP; oxygen if the blood oxygen level is low; and for smokers, treatment to stop smoking. (Medline Plus, 2014).

Respiratory alkalosis is a condition that changes the balance of carbon dioxide and oxygen in the blood. When you breathe, oxygen is inhaled into the lungs and carbon dioxide is exhaled. Normally these two gases are kept in balance by the respiratory system. Respiratory alkalosis occurs when carbon dioxide levels drop too low. This causes the pH of the blood to rise and become too alkaline. Some symptoms of respiratory alkalosis may include: dizziness, bloating, feeling light-headed, numbness and/or muscle spasms in the hands and feet, discomfort in the chest area, confusion, dry mouth, tingling in the arms, heart palpitations, and feeling short of breath. In severe cases the person may have a seizure. Hyperventilation is the underlying cause of respiratory alkalosis.

Hyperventilation is also known as over breathing. Some causes of hyperventilation is heart attack, pain, drug use, asthma, fever, COPD, infection, pulmonary embolism, and pregnancy. Changes in the physiochemical equilibrium due to the lowered pCO2 and this results in a slight decrease in HCO3. There is insufficient time for the kidneys to respond so this is the only change in an acute respiratory alkalosis (Healthline, 2014). Treatment is aimed at the condition that causes respiratory alkalosis. Breathing into a paper bag or using a mask that causes you to re-breathe carbon dioxide can sometimes help reduce symptoms (Medline Plus, 2014).

Normal blood pH is maintained between 7.35 and 7.45 by the regulatory systems. The lungs regulate the amount of carbon dioxide in the blood and the kidneys regular the bicarbonate. When the pH decreases to below 7.35 an acidosis condition is present. Alkalosis results when the pH is above 7.45 (Elmhurst College, 2014). Acceptable range for PaC02 is 35 to 45 mmHg. Acceptable range for HC03 is 22 to 26 mEq/l (Hansen Nursing, 2014).

Metabolic acidosis is a condition in which there is too much acid in the body fluids. It occurs when the bod produces too much acid, or when the kidneys are not removing enough acid from the body. There are several types of metabolic acidosis such as: Diabetic acidosis, which develops when acidic substances known as ketone bodies, build up in the body. This occurs with uncontrolled type 1 diabetes; hyperchloremic acidosis, results from excessive loss of sodium bicarbonate from the body. This can occur with severe diarrhea; Lactic acidosis, results from buildup of lactic acid. Lactic acid can be caused by alcohol, cancer, liver failure, and prolonged lack of oxygen from shock, heart failure, or severe anemia. Other causes for metabolic acidosis include: kidney disease, poisoning by aspirin, and severe dehydration. With metabolic acidosis, respiration will increase to blow off CO2, decreasing the amount of acid in the blood. In some cases, sodium bicarbonate may be given to reduce the acidity of the blood. (Medline Plus, 2014).

Metabolic alkalosis is a condition in which the body fluids have excess base. The kidneys and lungs maintain the proper balance of chemicals, called acids and bases, in the body. Decreased carbon dioxide or increased bicarbonate level makes the body too alkaline. There are different types of alkalosis such as: respiratory alkalosis, which is caused by a low carbon dioxide level in the blood. This can be due to: fever, lack of oxygen, lung disease, or liver disease; hypochloermic alkalosis is caused by an extreme lack or loss of chloride, from prolonged vomiting; hypokalemic alkalosis is caused by the kidneys’ response to an extreme lack of potassium, this can occur from taking certain water pills. Compensated alkalosis occurs when the body returns to the acid-base balance to normal in cases of alkalosis, but bicarbonate and carbon dioxide levels remain abnormal. Symptoms of alkalosis can include: confusion, hand tremor, light-headedness, muscle twitching, vomiting, and numbness or tingling in the face, hands, or feet. Treatment for alkalosis depends on the cause. For hyperventilation, breathing into a paper bag allows you to keep more carbon dioxide in your body. If your oxygen level is low you may receive oxygen. Medicines may be used to correct chemical loss (Medline Plus, 2014).

REFERENCES
Elmhurst College. (2014). Respiratory Acidosis. Retrieved from http://www.elmhurst.edu/~chm/vchembook/263respiratoryacid.html. Hansen Nursing. (2014). Normal Values. Retrieved from http://www.m2hnursing.com/ABG/normal_values.php. Healthline. (2014). Respiratory alkalosis. Retrieved from http://www.healthline.com/health/respiratory-alkalosis. Medline Plus. (2014). Alkalosis. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/001183.htm. Medline Plus. (2014). Respiratory acidosis. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000092.htm. Medline Plus. (2014). Respiratory alkalosis. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000111.htm. Medline Plus. (2014). Metabolic acidosis. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000335.htm.