Respiratory acidosis: Difference between revisions
m (Rossdonaldson1 moved page Respiratory Acidosis to Respiratory acidosis over redirect) |
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**if HCO3 > 24 + (pCO2-40)/10 x 3(+/-1) then suspect primary metabolic alkalosis | **if HCO3 > 24 + (pCO2-40)/10 x 3(+/-1) then suspect primary metabolic alkalosis | ||
===Etiology=== | |||
==Etiology== | |||
Hypoventilation - acute vs chronic | Hypoventilation - acute vs chronic | ||
== | ==Differential Diagnosis== | ||
#[[COPD]] | #[[COPD]] | ||
#Drugs ([[Opioid Overdose]]) | #Drugs ([[Opioid Overdose]]) | ||
| Line 20: | Line 19: | ||
#Pleural dz | #Pleural dz | ||
#Trauma | #Trauma | ||
==Diagnosis== | |||
==Treatment== | ==Treatment== | ||
#Improve alveolar ventilation | #Improve alveolar ventilation | ||
# | #*Bronchodilators | ||
# | #*CPAP | ||
# | #*[[Intubation]] (esp of pH < 7.25) | ||
# | #**Do not reduce pH too quickly (>5Hg/h) | ||
# | #***Can lead to abrupt [[Hypocalcemia]]/[[Hypokalemia]] | ||
==See Also== | ==See Also== | ||
[[Acid- | *[[Acid-base disorders]] | ||
== | ==References== | ||
[[Category:FEN]] | [[Category:FEN]] | ||
[[Category:Pulm]] | [[Category:Pulm]] | ||
[[Category:Tox]] | [[Category:Tox]] | ||
Revision as of 10:37, 20 July 2015
Background
- acidemia = pH < 7.38
- respiratory acidosis = pCO2 > 42
- Acute respiratory acidosis: Change in pH = 0.008 X (40 - PaCO2)
vs. Chronic respiratory acidosis: Change in pH = 0.003 X (40 - PaCO2)
- determine if another primary acid/base disturbance is occurring
- calculate AG
- if HCO3 < 24 + (pCO2-40)/10 x 3(+/-1) then there is a superimposed primary metabolic acidosis
- for every 10mm increase in pCO2 >40, HCO3expected increases by 2-4mEq (2 if acute/limited time for metabolic compensation, 4 if chronic i.e. COPD)
- if HCO3 > 24 + (pCO2-40)/10 x 3(+/-1) then suspect primary metabolic alkalosis
Etiology
Hypoventilation - acute vs chronic
Differential Diagnosis
- COPD
- Drugs (Opioid Overdose)
- Chest wall dz
- Pleural dz
- Trauma
Diagnosis
Treatment
- Improve alveolar ventilation
- Bronchodilators
- CPAP
- Intubation (esp of pH < 7.25)
- Do not reduce pH too quickly (>5Hg/h)
- Can lead to abrupt Hypocalcemia/Hypokalemia
- Do not reduce pH too quickly (>5Hg/h)