- Typical symptoms associated with a rapid increase in pCO2 include anxiety, dyspnea, confusion, hallucination, and psychosis; may progress to coma.
- A more gradual increase, as is seen with chronic respiratory acidosis, may cause memory impairment, sleep disturbances, personality changes, daytime somnolence, coordination impairment, tremors, myoclonic jerks, or asterixis.
- Acute respiratory acidosis – Acute hypercapnia typically follows sudden obstruction of the airway or generalized bronchospasm. The acute compensatory response for respiratory acidosis is an increase in the serum bicarbonate concentration by 1 meq/L for every 10 mmHg elevation in pCO2.
- Chronic respiratory acidosis – Chronic hypercapnia occurs in end-stage chronic obstructive pulmonary disease, restrictive lung disease with ventilatory muscle fatigue, or advanced states of intrapulmonary and extrapulmonary restrictive lung disease. With chronic acidosis, the kidneys increase acid excretion allowing for generation of additional HCO3, and the renal tubule increases HCO3 reabsorption, a process that takes 3-5 days to complete. The chronic response leads to a 4 meq/L increase in the serum bicarbonate concentration per 10 mmHg elevation in pCO2.
E87.2 – Acidosis
12326000 – Respiratory acidosis