Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content + • Inadequate respiration• Carbon dioxide accumulation ++ Epidemiology + • Etiologies include:-Acute airway obstruction-Aspiration-Respiratory arrest-Pulmonary infections-Pulmonary edema-Over sedation-Chronic respiratory failure ++ Symptoms and Signs + • Somnolence• None if chronic and well compensated ++ Laboratory Findings + • Decreased serum pH (< 7.35)• Increased Pco2 + • Causes may be neurologic, mechanical, or rarely from diffusion abnormality• May be acute or chronic + • ABG measurements• Plain chest film if pneumothorax is suspected or if endotracheal tube malposition or other anatomic consideration is of concern + • Restoration of adequate ventilation• Intubation, if necessary• Chronic-rapid correction may lead to severe metabolic alkalosis (post-hypercapneic metabolic alkalosis) ++ Surgery ++ Indications + • If unable to intubate, cricothyroidotomy may be necessary ++ Medications + • Sodium bicarbonate (rarely)• Narcotic antagonists• Benzodiazepine antagonists ++ Treatment Monitoring + • Serial ABG measurements ++ Complications + • Coma• Death ++ Prognosis + • Excellent if reversed quickly• Varies with etiology ++ Prevention + • Avoid over sedation ++ References ++Adrogue HJ et al. Management of life-threatening acid-base disorders. (Two parts.) N Engl J Med. 1998;338:26, 107. GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessSurgery 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessSurgery Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options