Respiratory acidosis: Difference between revisions
No edit summary |
No edit summary |
||
| Line 15: | Line 15: | ||
==DDX== | ==DDX== | ||
#COPD | #[[COPD]] | ||
#Drugs ( | #Drugs ([[Opioids]]) | ||
#Chest wall dz | #Chest wall dz | ||
#Pleural dz | #Pleural dz | ||
| Line 25: | Line 25: | ||
##Bronchodilators | ##Bronchodilators | ||
##CPAP | ##CPAP | ||
##Intubation (esp of pH < 7.25) | ##[[Intubation]] (esp of pH < 7.25) | ||
###Do not reduce pH too quickly (>5Hg/h) | ###Do not reduce pH too quickly (>5Hg/h) | ||
####Can lead to abrupt | ####Can lead to abrupt [[Hypocalcemia]]/[[Hypokalemia]] | ||
==See Also== | |||
[[Acid-Base]] | |||
==Source == | ==Source == | ||
Revision as of 08:15, 18 December 2013
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
DDX
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)
See Also
Source
Tintinalli, KAJI 2011