Mixed Respiratory & Metabolic Acidosis

When the blood's pH level is unbalanced and acid levels rise, a condition called acidosis develops. Respiratory acidosis occurs when there is too much carbon dioxide, an acid, in the blood. Metabolic acidosis occurs when there is not enough bicarbonate, an alkaline, in the blood. When your blood contains too much carbon dioxide and not enough bicarbonate, mixed respiratory and metabolic acidosis results.

Causes

• Respiratory acidosis is caused by the inability of the lungs to expel enough carbon dioxide from the body. It is seen in people who suffer from lung diseases, such as emphysema and severe pneumonia; patients with brain, nerve or muscle diseases that affect breathing; and people who are over-sedated. Metabolic acidosis is caused by conditions that result in abnormal metabolism, such as severe type 1 diabetes. Ingestion of substances that cannot be metabolized properly, such as wood alcohol, antifreeze or large amounts of aspirin, can also cause metabolic acidosis.

Symptoms

• Metabolic acidosis in its mildest state shows no outward symptoms but will progress to extreme weakness, drowsiness, confusion and nausea. Respiratory acidosis in its early form will cause headache and drowsiness. Left untreated, both forms of acidosis will result in falling blood pressure, shock, coma and death.

Treatment

• Once the underlying cause of the acidosis is identified, treatment for acidosis can include control of a metabolic disorder, improving lung function or removal of the toxic substance. In mild cases, intravenous fluid is administered; in severe cases, bicarbonate may be given intravenously.