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Acute respiratory acidosis occurs when an abrupt failure of ventilation occurs. This failure in ventilation may be caused by depression of the central respiratory center by cerebral disease or drugs, inability to ventilate adequately due to neuromuscular disease (e.g., myasthenia gravis, amyotrophic lateral sclerosis, Guillain–Barré syndrome, muscular dystrophy), or airway obstruction ...
As indicated by the Davenport diagram, respiratory depression, which results in a high P CO 2, will lower blood pH. Hyperventilation will have the opposite effects. A decrease in blood pH due to respiratory depression is called respiratory acidosis. An increase in blood pH due to hyperventilation is called respiratory alkalosis (Fig. 11).
There are four primary acid-base derangements that can occur in the human body - metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis. These are characterized by a serum pH below 7.4 (acidosis) or above 7.4 (alkalosis), and whether the cause is from a metabolic process or respiratory process.
The partial pressure of carbon dioxide, along with the pH, can be used to differentiate between metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis. Hypoventilation exists when the ratio of carbon dioxide production to alveolar ventilation increases above normal values – greater than 45mmHg.
This leads to the impaired oxygenation, which is the central problem of ARDS, as well as to respiratory acidosis. Respiratory acidosis in ARDS is often caused by ventilation techniques such as permissive hypercapnia, which attempt to limit ventilator-induced lung injury in ARDS. The result is a critical illness in which the 'endothelial disease ...
Adolf Kussmaul referred to breathing when metabolic acidosis was sufficiently severe for the respiratory rate to be normal or reduced. [2] This definition is also followed by several other sources, [3] [4] including for instance Merriam-Webster, which defines Kussmaul breathing as "abnormally slow deep respiration characteristic of air hunger and occurring especially in acidotic states". [5]
The amount of respiratory compensation in metabolic acidosis can be estimated using Winters' formula. [2] Hyperventilation due to the compensation for metabolic acidosis persists for 24 to 48 hours after correction of the acidosis, and can lead to respiratory alkalosis. [3] This compensation process can occur within minutes. [4]
One or a combination of these conditions may occur simultaneously. For instance, a metabolic acidosis (as in uncontrolled diabetes mellitus) is almost always partially compensated by a respiratory alkalosis (hyperventilation). Similarly, a respiratory acidosis can be completely or partially corrected by a metabolic alkalosis. [citation needed]