An aerial blood gas repo of pH: 7.00, PaO2:60 mm, Hg: PaCO2: 80 mm, HCO3:28

Respiratory acidosis Respiratory acidosis occurs when there is accumulation of CO2 due to type II respiratory failure (p. 565). This results in a rise in the PCO2, with a compensatory increase in plasma bicarbonate concentration, paicularly when the disorder is of long duration and the kidney has fully developed its capacity for increased acid excretion. This acid-base disturbance can arise from lesions anywhere along the neuromuscular pathways from the brain to the respiratory muscles that result in impaired ventilation. It can also arise during intrinsic lung disease if there is significant mismatching of ventilation and perfusion. Clinical features are primarily those of the underlying cause of the respiratory disorder, such as paralysis, chest wall injury or chronic obstructive lung disease, but the CO2 accumulation may itself lead to drowsiness that fuher depresses respiratory drive. Management involves correction of causative factors where possible, but ultimately ventilatory suppo may be necessary. Respiratory acidosis is an acid-base balance disturbance due to alveolar hypoventilation. ... Lung diseases that cause abnormalities in alveolar gas exchange do not typically result in alveolar hypoventilation. Often these diseases stimulate ventilation and hypocapnia due to reflex receptors and hypoxia Ref Davidson 23rd editing pg 367