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Chinese name: Introduction to respiratory acidosis respiratory acidosis disease is increased in the primary of the PCO2 and pH values decrease as the characteristics of hypercapnia. Symptoms Symptoms: As in the respiratory acidosis, increased blood H2CO3, lung function can not be compensated from the main row of the buffer system and the kidneys to regulate the acid base security. The main clinical manifestations are so a. difficulty breathing, hypoventilation, dyspnea, cyanosis, chest tightness and headache. b. increased acidosis, changes in consciousness occur, there are drowsiness, confusion, delirium, and coma. c.CO2 excessive product storage, in addition to blood pressure decline, there may be sudden ventricular fibrillation (the Na into the cell, K out of cells, acute hyperkalemia). d. test results: those with acute or decompensated blood pH value decreased, PCO2 increased, CO2CP, BE, SB, BB normal or slightly increased; those with chronic respiratory acidosis, or compensatory, pH value decreased obvious, PCO2 increased, CO2CP, BE, SB, BB has increased; blood K can be increased. Etiology etiology and pathogenesis of dysfunction caused by alveolar ventilation system. A. respiratory center is common in depression, such as narcotics overdose; b. respiratory tract obstruction, such as laryngospasm, bronchospasm, respiratory tract burns, foreign bodies, drowning, neck hematoma, or mass compression of the trachea, etc.; c. lung disease, such as shock lung, pulmonary edema


, atelectasis, pneumonia, etc.; d. thoracic injuries: such as surgery, trauma, pneumothorax, pleural effusions. Pathogenesis 1. Respiratory center inhibition of central nervous system diseases, such as extension of the brain tumor, extension of cerebral polio, encephalitis, meningitis, vertebral artery embolism or thrombosis, intracranial pressure, head injury, etc., respiratory center activity can be inhibited, so that ventilation to reduce the CO2 accumulation. In addition, some drugs such as narcotics, tranquilizers, sedatives (morphine, barbital sodium, etc.) have the role of inhibition of respiration, excessive doses can cause hypoventilation. Carbonic anhydrase inhibitors such as acetazolamide can cause metabolic acidosis mentioned before. It also inhibits carbonic anhydrase in red blood cells leaving CO2 released from red cells in the lung decreased, which led to increased arterial Pco2. The sick and wounded have a tendency to acidosis the drug should be used with caution. 2. Respiratory nerve and muscle dysfunction seen in polio, acute infectious polyneuritis (Guillain-barre syndrome) botulism, myasthenia gravis, hypokalemia, or familial periodic paralysis, spinal cord injury, etc. In severe cases, paralysis of respiratory muscles can be. 3. Thorax thoracic abnormalities of respiratory motion abnormalities are common after spinal, scoliosis, flail chest (Flail Chest), between ankylosing spondylitis (Ankylosing Spondylitis), cardiopulmonary obesity syndrome (Picwick syndrome) and so on. 4. The common airway obstruction foreign body obstruction, laryngeal edema and inhalation of vomit. 5. Diffuse lung disease is respiratory acidosis the most common cause. It includes chronic obstructive pulmonary disease, bronchial asthma, severe interstitial lung disease. These diseases can seriously impede the alveolar ventilation. 6.CO2 inhalation means high concentration of CO2 gas inhalation, such as trenches, tanks and other small space with poor ventilation of the environment. At this point does not reduce alveolar ventilation. Diagnosis of affected patients have a history of respiratory function, but also some of the symptoms of respiratory acidosis, that weakness should be suspected of having respiratory acidosis. Acute respiratory acidosis, blood gas analysis showed significantly decreased blood pH, PCO2 increased plasma HCO3- normal. Chronic respiratory acidosis, decreased blood pH value is not obvious, PCO2 increased plasma HCO3- increased. Treatment 1. To prevent and treat respiratory acidosis caused the original disease. 2. To improve alveolar ventilation, exhaust too much CO2. Feasible under the circumstances tracheotomy, artificial respiration, the lifting of bronchial spasm, expectorant, oxygen and other measures, the oxygen concentration when oxygen is not too high, so as not to suppress breathing. Artificial respiration should be appropriate, because the respiratory acidosis NaHCO3/H2CO3 increase in the primary H2CO3, NaH2CO3 showed a compensatory secondary increase. If hyperventilation is rapid decline in plasma Pco2, and NaHCO3 was still high, then the patient into the extracellular liquid caustic soda poisoning, the situation is so fluid. Can cause hypokalemia, decreased plasma Ca, central nervous system extracellular liquid caustic soda poisoning, coma and even death. 3. Generally do not give basic drugs, unless the pH decreased very drama, only temporarily due to the application of sodium bicarbonate to reduce acidosis, not long application. Patients with severe acidosis, such as coma, cardiac arrhythmia, treatment may be given THAM medium and high [H]. NaHCO3 solution can also be used, but must ensure adequate alveolar ventilation conditions can effect. As to correct the respiratory acidosis NaHCO3 body fluids high [H], can generate CO2, if not fully discharged, the depth will increase CO2. Prevention of common sense: respiratory acidosis, surgery mainly seen in the respiratory tract obstruction and chest surgery or trauma. Therapy to relieve airway obstruction and improve pulmonary ventilation function-based. Chronic bronchitis, pneumonia and other respiratory insufficiency caused by internal diseases, respiratory acidosis is more common, as detailed in respiratory failure.


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