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HWN Suggests

A Patient With Respiratory Acidosis...

So simplistically, we divide this into the patient won't breathe, can't breathe, or can't breathe enough. What do I mean by that? So if you think about it, if the problem is in the central nervous system, where there is not enough stimulus to the respiratory centers in the brain, the patient won't breathe.

Or the patient can't breathe adequately due to issues either with the peripheral nerves, the neuromuscular junction or chest muscle weakness or chest wall and plural issues or with issues in the upper area airways.

The last one is where a person can have respiratory acidosis, which can occur because the patient cannot breathe enough, which is due to an abnormal gas exchange…

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Articles of Interest

Bicarbonate for Respiratory Acidosis: Not So Fast

We all like to make the numbers pretty in our critically ill patient. Euboxic is a term that is thrown out there. It’s like there’s a check box in our brains that we need to fill in when turning a lab value back to the default color rather than red in our EMR. But one of those that we should potentially let ride is to provide sodium bicarbonate to patients whose acidosis is driven by an elevated CO2. In other words, providing bicarbonate for a respiratory acidosis.

Hypercapnia (Respiratory Acidosis): Causes & Symptoms

Ventilation, or assisted breathing, is the standard method of management for respiratory failure resulting from hypercapnia. Non-invasive ventilation is the primary strategy used, which refers to breathing support using a mask or similar device instead of inserting an artificial airway.

Respiratory acidosis (hypercapnia)

There is no universal approach to treating hypercapnia, since this will vary widely depending on the clinical context. Among patients with chronic hypercapnia, the therapeutic goal is generally to return the patient to their baseline pCO2 level.

Resources

Life in the Fastlane

Monitoring with capnography -> the end-tidal pCO2 is typically lower than the arterial pCO2 and the difference between these values is an index of the magnitude of the alveolar dead space -> so if the end-tidal pCO2 is elevated then the arterial pCO2 is usually even more elevated.

StatPearls

This activity reviews the evaluation and management of hypercarbia and highlights the role of the interprofessional team in evaluating and improving care for patients with this condition.