Page 1 of 1: Acid-base and the Respiratory System

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The respiratory system is an important regulator of acid-base balance.
• CO2 combines with water to form carbonic acid.
• Carbonic acid dissociates immediately to H+ and HCO3-
• Changes in ventilation affect PCO2, and therefore the body's acid-base status.
• Respiratory acidosis and alkalosis are the two types of disturbance caused by changes in ventilation.
• The lungs can also compensate for metabolic disturbances by altering ventilation; unlike the renal system they can react quickly.
Respiratory Acidosis:
• CO2 is increased.
• Respiratory acidosis results from hypoventilation or ventilation:perfusion mismatch.
• It can occur in many respiratory diseases including asthma, a blocked airway or collapsed lung.
• Drugs that reduce respiratory drive (e.g. morphine or barbiturates) may cause respiratory acidosis.
• The renal system may act to compensate, but this takes time.
Respiratory Alkalosis:
• CO2 is reduced.
• Respiratory alkalosis generally results from hyperventilation or blowing off too much CO2.
• It can be stimulated by hypoxic drive in diseases such as chronic obstructive pulmonary disease (see below)
• Damage to the brainstem, some drugs (e.g. aspirin) and hysterical overbreathing can also cause respiratory alkalosis.
• The renal system may act to compensate, but this takes time.

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