Signs and symptoms of respiratory acidosis. The effects of respiratory acidosis on the central nervous system are collectively known as hypercapnic encephalopathy. Factors responsible for its development include the magnitude and time course of the hypercapnia, severity of the acidemia, and degree of attendant hypoxemia. Progressive narcosis and coma may occur in patients receiving uncontrolled oxygen therapy in whom levels of arterial carbon dioxide tension (PaCO2) may reach or exceed 100 mm Hg. The hemodynamic consequences of carbon dioxide retention reflect several mechanisms, including direct impairment of myocardial contractility, systemic vasodila-tion caused by direct relaxation of vascular smooth muscle, sympathetic stimulation, and acidosis-induced blunting of receptor responsiveness to catecholamines. The net effect is dilation of systemic vessels, including the cerebral circulation; whereas vasoconstriction might develop in the pulmonary and renal circulations. Salt and water retention commonly occur in chronic hypercapnia, especially in the presence of cor pulmonale. Mechanisms at play include hypercapnia-induced stimulation of the renin-angiotensin-aldosterone axis and the sympathetic nervous system, elevated levels of cortisol and antidiuretic hormone, and increased renal vascular resistance. Of course, coexisting heart failure amplifies most of these mechanisms [1,2].


Cerebrum _

Voluntary control


Brain stem

Automatic control

Relaxation Audio Sounds Dusk At The Oasis

Relaxation Audio Sounds Dusk At The Oasis

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