What IS Respiratory Acidosis?
Process of producing acid (H+) because of retention of CO2 by a decrease in alveolar ventilation. Almost always due to hypoventilation.
Questions?
What type of patients would you expect?
- Pulmonary Issues: COPD, pneumonia, atelectasis
- Neuropathies Guillain-Barre Syndrome, Myasthenia gravis
- Neuromuscular: MD, SCI
- CNS: sedatives, depression, narcotics
Acute versus Chronic Respiratory Acidosis
Acute: sudden failure in ventilation; pH abnormal and kidneys don’t have time to compensate (***medical emergency)
Chronic: long term pulmonary disease; kidneys have time to compensate; pH within tolerable limits
Chronic: long term pulmonary disease; kidneys have time to compensate; pH within tolerable limits
Signs and Symptoms of Respiratory Acidosis
What is Respiratory Alkalosis?
Process of reducing arterial blood acid (H+) (without compensation) because of blowing off CO2 by an increase in alveolar ventilation. Opposite of respiratory acidosis.
Questions?
What type of patients would you expect?
- Pulmonary: Due to hypoxemia in pulmonary issues i.e., pulmonary edema, pulmonary embolism, pneumonia, asthma or overuse of mechanical ventilator.
- Non-pulmonary: anxiety; hysteria, pain, hypoxia, fever, early CVA; CNS diseases.
Signs and Symptoms of Respiratory Alkalosis
- *Cardinal sign is deep rapid breathing >40 bpm
- Dizziness or being light headed
- Inability to concentrate
- Diaphoresis
- Dry mouth
- Muscle cramps
- Severe Respiratory Alkalosis: cardiac arrhythmia's, convulsions and syncope
What is Metabolic Acidosis
Process of increasing acid (H+) in the blood by ingestion, infusion,OR production of a fixed acid or by eliminating HCO3
Questions?
What type of conditions would you expect?
Someone with ketoacidosis may have their breath smell like what?
Someone with ketoacidosis may have their breath smell like what?
Signs and Symptoms of Metabolic Acidosis
- Muscle twitching
- Weakness
- Malaise
- Nausea
- Vomiting
IF SEVERE
Stupor, unconsciousness, coma and death
What is Metabolic Alkalosis
Either an abnormal loss of acid or excess accumulation of bicarbonate.
Hospital setting: ¨associated with hypokalemia secondary to certain meds i.e., diuretics, steroids. Also could be caused by post-operative vomiting.
Outpatient setting: excessive use of antacids with peptic ulcers
Hospital setting: ¨associated with hypokalemia secondary to certain meds i.e., diuretics, steroids. Also could be caused by post-operative vomiting.
Outpatient setting: excessive use of antacids with peptic ulcers
Signs and Symptoms of Metabolic Alkalosis
- Hypoventilation
- Muscle weakness
- Irritability
- Confusion
- Muscle Twitching
- Comatose, convulsion, seizures
References
- Goodman CC, Snyder TE In: Goodman CC, Fuller KS, Boissonnault WG. Pathology: Implications for the physical therapist. 2nd ed. Philadelphia PA: Saunders, Inc; 2003:115-116.
- Frownfelter D, Butler-McNamara SM. In: Frownfelter D, Dean E. Cardiovascular and Pulmonary Physical Therapy: Evidence in Practice. 5th ed. St. Louis, Missouri: Mosby Inc; 2012: 143-150.