Respiratory Acidosis

General Principles

The causes of respiratory acidosis can be divided into hypoventilation from (1) respiratory center depression, (2) neuromuscular failure, (3) decreased respiratory system compliance, (4) increased airway resistance, and (5) increased dead space (see Table 12-3).


  • Symptoms of respiratory acidosis result from changes in the cerebrospinal fluid (CSF) pH. A very severe hypercapnia may be well tolerated if it is accompanied by renal compensation and a relatively normal pH. Conversely, a modest rise in pCO2 can be very symptomatic if acute.
  • Initial symptoms and signs may include headache and restlessness, which may progress to generalized hyperreflexia/asterixis and coma.

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