Respiratory acidosis medical therapy

Jump to: navigation, search

Respiratory acidosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Respiratory acidosis from other Diseases

Epidemiology and Demographics

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Future or Investigational Therapies

Case Studies

Case #1

Respiratory acidosis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Respiratory acidosis medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Respiratory acidosis medical therapy

CDC on Respiratory acidosis medical therapy

Respiratory acidosis medical therapy in the news

Blogs on Respiratory acidosis medical therapy

Directions to Hospitals Treating Respiratory acidosis

Risk calculators and risk factors for Respiratory acidosis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S[2]

Overview

The mainstay of treatment for respiratory acidosis is treating the underlying disorder which is responsible for the condition.While correcting hypercapnia extra care should be taken because rapid correction of the hypercapnia can result in metabolic alkalemia and can result in seizures especially when cerebrospinal fluid (CSF) becomes alkaline.Indications for admitting the patient in intensive care unit (ICU) when a patient presents with a low pH of (< 7.25), confusion, lethargy and respiratory muscle weakness.

Medical Therapy

  • Pharmacologic medical therapy is recommended for patients who are taking sedatives.[1][2]
  • For patients who are suspected of drug overdose administration of antidote is considered when the physician think it safe.
    • Preferred regimen (1): Naloxone 0.05 mg intravenously (IV) as an initial
    • In apneic patients give Naloxone 0.2 to 1 mg as an initial dose.
    • In cardiorespiratory arrest give Naloxone  2 mg as an initial dose.
    • Preferred regimen (2): Flumazenil 0.2 mg given IV over 30 seconds as an initial dose.
    • 0.2 mg to a maximum dose of 1 mg of Flumazenil should be considered but not more than that for an initial dose in an adult.
    • Overall not more than 3 mg of flumazenil should be given.

Bag-valve mask ventilation[3]

 Oxygen[4][5][6]

  • In patients with severe hypoxemia it is necessary to administer oxygen to avoid life threatening complications.
  • Goals to administer oxygen:
    • 1)The primary goal is to treat hypoxemia.
    • 2) The second goal is to prevent worsening of hypercapnia.

References

  1. Belghiti J, Wind P, Bernades P, Fékété F (November 1987). "Acute pancreatitis associated with carcinoma of the ampulla of Vater". Br J Surg. 74 (11): 1067–8. PMID 3690240.
  2. Epstein SK, Singh N (April 2001). "Respiratory acidosis". Respir Care. 46 (4): 366–83. PMID 11262556.
  3. Belghiti J, Wind P, Bernades P, Fékété F (November 1987). "Acute pancreatitis associated with carcinoma of the ampulla of Vater". Br J Surg. 74 (11): 1067–8. PMID 3690240.
  4. Rudolf M, Banks RA, Semple SJ (September 1977). "Hypercapnia during oxygen therapy in acute exacerbations of chronic respiratory failure. Hypothesis revisited". Lancet. 2 (8036): 483–6. PMID 70692.
  5. O'Driscoll BR, Howard LS, Earis J, Mak V (June 2017). "BTS guideline for oxygen use in adults in healthcare and emergency settings". Thorax. 72 (Suppl 1): ii1–ii90. doi:10.1136/thoraxjnl-2016-209729. PMID 28507176.
  6. Durrington HJ, Flubacher M, Ramsay CF, Howard LS, Harrison BD (July 2005). "Initial oxygen management in patients with an exacerbation of chronic obstructive pulmonary disease". QJM. 98 (7): 499–504. doi:10.1093/qjmed/hci084. PMID 15955796.

Linked-in.jpg