Respiratory Acidosis

Impaired ventilation reduces CO2 excretion, increases PaCO , and thus lowers pH. This may occur acutely or chronically. Causes of respiratory acidosis include factors that interfere with the neurological 'drive' for respiration (e.g., head injury, cardiac arrest, opiate and anesthetic drugs), diseases of the respiratory muscles (e.g., poliomyelitis, Guillain-Barré syndrome), or primary lung diseases (acute pulmonary edema or pneumonia, chronic bronchitis or emphysema). In acute conditions, pH may fall dramatically, whereas in chronic conditions, such as chronic lung disease, the pH is generally nearer normal. In chronic conditions complete compensation occurs in the kidney where elevated PaCO2 levels are offset by the increased generation of bicarbonate and excretion of fixed acid by the kidney, to balance the Henderson-Hasselbalch equation.

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