Too much carbon dioxide in the body results in respiratory acidosis, when the lungs are no longer efficiently exchanging oxygen and carbon dioxide, causing an acid-base imbalance. When this happens, the imbalance causes body fluids, particularly blood, to become too acidic. Acute respiratory acidosis occurs quickly before the kidneys can compensate. Chronic respiratory acidosis takes much longer, allowing the kidneys to compensate by increasing the body's level of bicarbonate. This condition is called compensated respiratory acidosis. Acid-base balance is dependent upon the balance of bicarbonate or base, and carbon dioxide or acid in the body. If the acid or base is out of balance, the body will try to compensate.
Asthma and Chronic Obstructive Pulmonary Disease
Airway diseases such as asthma, emphysema and chronic bronchitis can cause the alveoli or air sacs in the lungs to allow the air in, but makes it difficult to breathe the air out. This leads to carbon dioxide retention. In an acute situation such as an asthma attack, when the body is reacting to an allergen, this carbon dioxide retention happens quickly, causing respiratory acidosis. The kidneys will try to compensate by increasing the level of bicarbonate in the body, but this process can take several hours to several days.
Chest Deformity
Chest deformities from paralysis, cerebral palsy, spina bifida, chronic lung disease, trauma and other conditions will physically restrict the lungs' ability to load oxygen and release carbon dioxide. When an individual suddenly becomes ill, respiratory failure can occur because of uncompensated respiratory acidosis.
Drugs
Narcotics can suppress the respiratory drive, allowing the accumulation of carbon dioxide. As soon as the carbon dioxide level begins to rise, the kidneys try to compensate by releasing bicarbonate. However, kidney response has a much slower onset then the respiratory response. Certain drugs can also prevent the kidneys from compensating. Full compensation or returning the body to an acid-base balance can sometimes take days.
Obesity or Injury
Obesity can limit chest excursion or the lungs' ability to expand and contract, causing the carbon dioxide levels to rise. Obese individuals are often told to sleep in a reclining position in order to allow the lungs to expand more easily. Obese individuals often suffer from chronic respiratory acidosis, as they chronically are unable to maintain a stable acid-base balance. These individuals also suffer from chronic shortness of breath, lethargy and chronic fatigue, which makes their condition even worse.
