Consequences of respiratory acidosis and alkalosis

Consequences of Respiratory Acidosis

Consequences of Respiratory Alkalosis

Respiratory consequences:

• Increased respiratory stimulus (maximum at 65mmHg)
• Increased work of breathing
• Alveolar hypoxia (on room air)
• Right shift of the oxyhaemoglobin dissociation curve
  • With a chronically raised PaCO₂, a decrease in 2,3-DPG drives the curve back to the left

Cardiovascular consequences:

• Increased sympathetic tone
• Peripheral vasodilation
• Increased cardiac output
• Increased blood pressure
• Prolonged QTc

Neurological consequences

• Cerebral vasodilation; headache and increased intracranial pressure
• CNS depression and a decreased level of consciousness

Electrolyte derangement

• Raised HCO₃^-
• Hypochloraemia due to Hamburger shift

Respiratory consequences

• Depression of respiratory drive
• Left shift of oxyhemoglobin dissociation curve
• Peripheral vasoconstriction

Cardiovascular consequences

• Arrhythmias
• Decreased cardiac output

Neurological consequences

• Decreased cerebral perfusion
• Lowering of the seizure threshold
• Hypocalcemia; thus:
  • Paraesthesia
  • Carpopedal spasm