- Severe respiratory disease e.g. obstructive air way disease and severe
obesity. - Central depression of respiratory drive.
Clinical features:
1- Manifestations of the cause.
2- Confusion, hyperreactivity, headache, tremor, stupor and coma in
severe cases.
3- Papilloedema and increased CSF pressure due to V.D.
4- Pulmonary and splanchnic V.C.
Treatment:
1- Treatment of the etiologic cause
2- If there is respiratory failure, assisted respiration (ventilator) should be
provided.
Metabolic Alkalosis
Because of the high capacity of the kidney to secrete HCo 3 - ,
metabolic alkalosis can only persist if there is a renal dysfunction with a
reduction in HCo 3 - excretion or enhanced renal generation of HCo 3 -.
Features:
- High plasma HCo 3 - (> 30 mmol/litre)
- High plasma pH (pH > 7.45)
- High Pco 2 , for every 1 mmol/litre increase in plasma HCo 3 - there will
be a 0.6-0.7 increase in Pco 2. Hypoxaemia stands as a limiting factor
for the respiratory compensation. So, if it exists, we have to give
oxygen support.