Diagnosis and management of severe respiratory acidosis: a 65-year-old man with a double-lung transplant and shortness of breath.
Respiratory acidosis is characterized by a primary increase in whole-body carbon dioxide stores caused by a positive carbon dioxide balance. This acid-base disorder, if severe, may be life-threatening, therefore requiring prompt recognition and expert management. The case presented highlights the essential features of the diagnosis and management of respiratory acidosis. A brief description of the modifiers of carbon dioxide production, the pathogenesis of respiratory acidosis, and an algorithm for assessment and management of this disorder is included. Key teaching points include the clinical value of both arterial and venous blood gas analyses and the importance of proper recognition of a primary respiratory arrest in contrast to primary circulatory arrest when managing a patient who requires resuscitation from "cardiorespiratory arrest."
Adrogué
Horacio J
HJ
Department of Medicine, Baylor College of Medicine, Houston, TX, USA. hadrogue@bcm.tmc.edu
D000142:Acidosis, Respiratory / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001784:Blood Gas Analysis / Q000379:methods; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D011658:Pulmonary Fibrosis / Q000601:surgery*; D012121:Respiration, Artificial / Q000379:methods*; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents