Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Am J Kidney Dis. 2010 Nov;56(5):994-1000. doi: 10.1053/j.ajkd.2010.04.024. Epub 2010 Jul 29.
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."
呼吸性酸中毒的特征是全身二氧化碳储存量的原发性增加，这是由于二氧化碳平衡呈阳性所致。如果这种酸碱失衡严重，可能会危及生命，因此需要迅速识别并由专业人员进行管理。本病例突出了呼吸性酸中毒诊断和管理的基本特征。文中简要描述了二氧化碳生成的调节剂、呼吸性酸中毒的发病机制以及这种疾病评估和管理的算法。关键教学要点包括动脉和静脉血气分析的临床价值，以及在管理需要从“心肺骤停”复苏的患者时，正确识别原发性呼吸停止与原发性循环停止的重要性。
