respiratory acidosis

Summary

Summary: Respiratory retention of carbon dioxide. It may be chronic or acute.

Top Publications

  1. Swenson E. Therapeutic hypercapnic acidosis: pushing the envelope. Am J Respir Crit Care Med. 2004;169:8-9 pubmed
  2. Laffey J, O Croinin D, McLoughlin P, Kavanagh B. Permissive hypercapnia--role in protective lung ventilatory strategies. Intensive Care Med. 2004;30:347-56 pubmed
    ..Rapidly advancing basic scientific investigations should better delineate the advantages, disadvantages, and optimal use of hypercapnia in ARDS...
  3. Djerad A, Monier C, Houze P, Borron S, Lefauconnier J, Baud F. Effects of respiratory acidosis and alkalosis on the distribution of cyanide into the rat brain. Toxicol Sci. 2001;61:273-82 pubmed
    The aim of this study was to determine whether respiratory acidosis favors the cerebral distribution of cyanide, and conversely, if respiratory alkalosis limits its distribution...
  4. Tournadre J, Allaouchiche B, Malbert C, Chassard D. Metabolic acidosis and respiratory acidosis impair gastro-pyloric motility in anesthetized pigs. Anesth Analg. 2000;90:74-9 pubmed
    ..We investigated the effects of metabolic (MA) and respiratory acidosis (RA) on upper gut motility in tracheally ventilated pigs whose anesthesia was induced with halothane and ..
  5. Cham G, Tan W, Earnest A, Soh C. Clinical predictors of acute respiratory acidosis during exacerbation of asthma and chronic obstructive pulmonary disease. Eur J Emerg Med. 2002;9:225-32 pubmed
    ..This study aimed to provide a clinical means of identifying patients with acute respiratory acidosis (ARA) in a setting where blood gas analysis is unavailable...
  6. Kregenow D, Rubenfeld G, Hudson L, Swenson E. Hypercapnic acidosis and mortality in acute lung injury. Crit Care Med. 2006;34:1-7 pubmed
    ..We tested the hypothesis that hypercapnic acidosis is associated with reduced mortality rate in patients with acute lung injury independent of changes in mechanical ventilation...
  7. Frick K, Bushinsky D. Effect of metabolic and respiratory acidosis on intracellular calcium in osteoblasts. Am J Physiol Renal Physiol. 2010;299:F418-25 pubmed publisher
    ..Conversely, respiratory acidosis [decreased pH from increased partial pressure of carbon dioxide (Pco(2))] does not appreciably alter Ca ..
  8. Frick K, Bushinsky D. In vitro metabolic and respiratory acidosis selectively inhibit osteoblastic matrix gene expression. Am J Physiol. 1999;277:F750-5 pubmed
    ..either a reduction in bicarbonate concentration ([HCO(-)(3)], metabolic acidosis) or an increase in PCO(2) (respiratory acidosis)...
  9. Gattinoni L, Taccone P, Carlesso E. Respiratory acidosis: is the correction with bicarbonate worth?. Minerva Anestesiol. 2006;72:551-7 pubmed
    ..The effect is independent on (HCO3-) infusion and equivalent to adding (Na+ OH-) instead of (Na+ HCO3-)...
  10. Tuggey J, Plant P, Elliott M. Domiciliary non-invasive ventilation for recurrent acidotic exacerbations of COPD: an economic analysis. Thorax. 2003;58:867-71 pubmed
    ..We present economic data on the impact of domiciliary NIV on the need for admission to hospital and its attendant costs...

Scientific Experts

Detail Information

Publications62

  1. Swenson E. Therapeutic hypercapnic acidosis: pushing the envelope. Am J Respir Crit Care Med. 2004;169:8-9 pubmed
  2. Laffey J, O Croinin D, McLoughlin P, Kavanagh B. Permissive hypercapnia--role in protective lung ventilatory strategies. Intensive Care Med. 2004;30:347-56 pubmed
    ..Rapidly advancing basic scientific investigations should better delineate the advantages, disadvantages, and optimal use of hypercapnia in ARDS...
  3. Djerad A, Monier C, Houze P, Borron S, Lefauconnier J, Baud F. Effects of respiratory acidosis and alkalosis on the distribution of cyanide into the rat brain. Toxicol Sci. 2001;61:273-82 pubmed
    The aim of this study was to determine whether respiratory acidosis favors the cerebral distribution of cyanide, and conversely, if respiratory alkalosis limits its distribution...
  4. Tournadre J, Allaouchiche B, Malbert C, Chassard D. Metabolic acidosis and respiratory acidosis impair gastro-pyloric motility in anesthetized pigs. Anesth Analg. 2000;90:74-9 pubmed
    ..We investigated the effects of metabolic (MA) and respiratory acidosis (RA) on upper gut motility in tracheally ventilated pigs whose anesthesia was induced with halothane and ..
  5. Cham G, Tan W, Earnest A, Soh C. Clinical predictors of acute respiratory acidosis during exacerbation of asthma and chronic obstructive pulmonary disease. Eur J Emerg Med. 2002;9:225-32 pubmed
    ..This study aimed to provide a clinical means of identifying patients with acute respiratory acidosis (ARA) in a setting where blood gas analysis is unavailable...
  6. Kregenow D, Rubenfeld G, Hudson L, Swenson E. Hypercapnic acidosis and mortality in acute lung injury. Crit Care Med. 2006;34:1-7 pubmed
    ..We tested the hypothesis that hypercapnic acidosis is associated with reduced mortality rate in patients with acute lung injury independent of changes in mechanical ventilation...
  7. Frick K, Bushinsky D. Effect of metabolic and respiratory acidosis on intracellular calcium in osteoblasts. Am J Physiol Renal Physiol. 2010;299:F418-25 pubmed publisher
    ..Conversely, respiratory acidosis [decreased pH from increased partial pressure of carbon dioxide (Pco(2))] does not appreciably alter Ca ..
  8. Frick K, Bushinsky D. In vitro metabolic and respiratory acidosis selectively inhibit osteoblastic matrix gene expression. Am J Physiol. 1999;277:F750-5 pubmed
    ..either a reduction in bicarbonate concentration ([HCO(-)(3)], metabolic acidosis) or an increase in PCO(2) (respiratory acidosis)...
  9. Gattinoni L, Taccone P, Carlesso E. Respiratory acidosis: is the correction with bicarbonate worth?. Minerva Anestesiol. 2006;72:551-7 pubmed
    ..The effect is independent on (HCO3-) infusion and equivalent to adding (Na+ OH-) instead of (Na+ HCO3-)...
  10. Tuggey J, Plant P, Elliott M. Domiciliary non-invasive ventilation for recurrent acidotic exacerbations of COPD: an economic analysis. Thorax. 2003;58:867-71 pubmed
    ..We present economic data on the impact of domiciliary NIV on the need for admission to hospital and its attendant costs...
  11. Laffey J, Honan D, Hopkins N, Hyvelin J, Boylan J, McLoughlin P. Hypercapnic acidosis attenuates endotoxin-induced acute lung injury. Am J Respir Crit Care Med. 2004;169:46-56 pubmed
    ..The beneficial actions of hypercapnic acidosis were not mediated by inhibition of peroxynitrite-induced nitration within proteins...
  12. Perry S, Furimsky M, Bayaa M, Georgalis T, Shahsavarani A, Nickerson J, et al. Integrated responses of Na+/HCO3- cotransporters and V-type H+-ATPases in the fish gill and kidney during respiratory acidosis. Biochim Biophys Acta. 2003;1618:175-84 pubmed
    ..In trout, the levels of gill NBC1 mRNA were increased markedly during respiratory acidosis induced by exposure to hypercarbia; this response was accompanied by a transient increase in branchial V-..
  13. Martinu T, Menzies D, Dial S. Re-evaluation of acid-base prediction rules in patients with chronic respiratory acidosis. Can Respir J. 2003;10:311-5 pubmed
    The prediction rules for the evaluation of the acid-base status in patients with chronic respiratory acidosis, derived primarily from an experimental canine model, suggest that complete compensation should not occur...
  14. Brogan T, Robertson H, Lamm W, Souders J, Swenson E. Carbon dioxide added late in inspiration reduces ventilation-perfusion heterogeneity without causing respiratory acidosis. J Appl Physiol (1985). 2004;96:1894-8 pubmed
    ..improves ventilation-perfusion (Va/Q) matching but with the consequence of mild arterial hypercapnia and respiratory acidosis. We hypothesized that adding CO2 only late in inspiration to limit its effects to the conducting airways ..
  15. Antonelli M, Pennisi M, Pelosi P, Gregoretti C, Squadrone V, Rocco M, et al. Noninvasive positive pressure ventilation using a helmet in patients with acute exacerbation of chronic obstructive pulmonary disease: a feasibility study. Anesthesiology. 2004;100:16-24 pubmed
    ..Whether it is feasible to treat these patients with NPPV delivered by a helmet is not known...
  16. Sinclair S, Kregenow D, Lamm W, Starr I, Chi E, Hlastala M. Hypercapnic acidosis is protective in an in vivo model of ventilator-induced lung injury. Am J Respir Crit Care Med. 2002;166:403-8 pubmed
    ..18 x 10(5) versus 2.84 x 10(5) +/- 0.28 x 10(5) nucleated cells/ml; p = 0.021), and injury score (7.0 +/- 3.3 versus 0.7 +/- 0.9; p < 0.0001). We conclude that hypercapnic acidosis is protective against VILI in this model...
  17. Takil A, Eti Z, Irmak P, Yilmaz Göğüş F. Early postoperative respiratory acidosis after large intravascular volume infusion of lactated ringer's solution during major spine surgery. Anesth Analg. 2002;95:294-8, table of contents pubmed
    ..Although intraoperative 20 mL. kg(-1). h(-1) LR infusion does not cause hyperchloremic metabolic acidosis as does NS infusion, it leads to postoperative respiratory acidosis and mild hyponatremia.
  18. Epstein S, Singh N. Respiratory acidosis. Respir Care. 2001;46:366-83 pubmed
    b>Respiratory acidosis, or primary hypercapnia, is the acid-base disorder that results from an increase in arterial partial pressure of carbon dioxide...
  19. Phillis J, Song D, O Regan M. Mechanisms involved in coronary artery dilatation during respiratory acidosis in the isolated perfused rat heart. Basic Res Cardiol. 2000;95:93-7 pubmed
    ..heart preparation, perfused at constant pressure, was used to evaluate the role of K(ATP) channels in respiratory acidosis-induced coronary hyperemia...
  20. Plant P, Owen J, Elliott M. One year period prevalence study of respiratory acidosis in acute exacerbations of COPD: implications for the provision of non-invasive ventilation and oxygen administration. Thorax. 2000;55:550-4 pubmed
    ..intubation rates in patients with chronic obstructive pulmonary disease (COPD) admitted to hospital with respiratory acidosis. This study aimed to determine the prevalence of respiratory acidosis in patients admitted with COPD, to ..
  21. Broccard A, Hotchkiss J, Vannay C, Markert M, Sauty A, Feihl F, et al. Protective effects of hypercapnic acidosis on ventilator-induced lung injury. Am J Respir Crit Care Med. 2001;164:802-6 pubmed
    To investigate whether respiratory acidosis modulates ventilator-induced lung injury (VILI), we perfused (constant flow) 21 isolated sets of normal rabbit lungs, ventilated them for 20 min (pressure controlled ventilation [PCV] = 15 cm H(..
  22. Vargas F, Bui H, Boyer A, Salmi L, Gbikpi Benissan G, Guénard H, et al. Intrapulmonary percussive ventilation in acute exacerbations of COPD patients with mild respiratory acidosis: a randomized controlled trial [ISRCTN17802078]. Crit Care. 2005;9:R382-9 pubmed
    ..IPV), a technique designed to improve mucus clearance, could prove effective in avoiding further deterioration in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) with mild respiratory acidosis.
  23. Watanabe Y, Dohi S, Iida H, Ishiyama T. The effects of bupivacaine and ropivacaine on baroreflex sensitivity with or without respiratory acidosis and alkalosis in rats. Anesth Analg. 1997;84:398-404 pubmed
    ..causes cardiac and central nervous system (CNS) depression that could be enhanced in the presence of respiratory acidosis. We examined a potential suppression of baroreflex function with bupivacaine and ropivacaine during ..
  24. Wade C, Wang T, Lang K, Corbin B, Steele M. Rat growth, body composition, and renal function during 30 days increased ambient CO2 exposure. Aviat Space Environ Med. 2000;71:599-609 pubmed
    ..In experiments using rodents onboard orbiting spacecraft, specimens may be exposed to an increase in ambient CO2...
  25. Schwarz C, Oberbauer R. [Acid-base balance]. Wien Klin Wochenschr. 2007;119:21-37; quiz 38 pubmed
  26. Adrogue H. Diagnosis and management of severe respiratory acidosis: a 65-year-old man with a double-lung transplant and shortness of breath. Am J Kidney Dis. 2010;56:994-1000 pubmed publisher
    b>Respiratory acidosis is characterized by a primary increase in whole-body carbon dioxide stores caused by a positive carbon dioxide balance...
  27. Terragni P, Del Sorbo L, Mascia L, Urbino R, Martin E, Birocco A, et al. Tidal volume lower than 6 ml/kg enhances lung protection: role of extracorporeal carbon dioxide removal. Anesthesiology. 2009;111:826-35 pubmed publisher
    ..The authors verified whether VT lower than 6 ml/kg may enhance lung protection and that consequent respiratory acidosis may be managed by extracorporeal carbon dioxide removal.
  28. Derekoy F, Fidan H, Fidan F, Aktepe F, Kahveci O. Tonsillar lipoma causing difficult intubation: a case report. Kulak Burun Bogaz Ihtis Derg. 2007;17:329-32 pubmed
    ..An emergency intubation was planned due to the development of respiratory acidosis and hypoxemia, but the patient could not be intubated...
  29. Brown S, Howden R. The effects of a respiratory acidosis on human heart rate variability. Adv Exp Med Biol. 2008;605:361-5 pubmed
    Human heart rate variability (HRV) was examined during a mild respiratory acidosis induced by inhalation of a normoxic hypercapnic gas mixture...
  30. Gøthgen I. What is the lower limits of arterial pO2?. Acta Anaesthesiol Scand. 2007;51:393-4 pubmed
  31. Shibasaki M, Okano K, Kageyama K, Nakajima Y, Ibuki T, Tanaka Y. [Perioperative management of a neonate with a retroperitoneal giant teratoma who underwent its extirpation under general anesthesia: a case report]. Masui. 2005;54:1302-5 pubmed
    ..We report the difficulty for management during anesthesia because of severe respiratory acidosis due to pressure from diaphragmatic pleura by tumor, severe circulatory disorder due to massive bleeding ..
  32. Bin Jaliah I, Maskell P, Kumar P. Indirect sensing of insulin-induced hypoglycaemia by the carotid body in the rat. J Physiol. 2004;556:255-66 pubmed
    ....
  33. Bordier P, Garrigue S, Reuter S, Bordachar P, Clementy J. Death during polysomnography of a patient with cheyne-stokes respiration, respiratory acidosis, and chronic heart failure. Chest. 2004;126:1698-700 pubmed
    ..This report illustrates a case of respiratory drive failure during sleep as the mode of death in a patient with heart failure, sleep apnea syndrome, and CRF...
  34. Doerr C, Gajic O, Berrios J, Caples S, Abdel M, Lymp J, et al. Hypercapnic acidosis impairs plasma membrane wound resealing in ventilator-injured lungs. Am J Respir Crit Care Med. 2005;171:1371-7 pubmed
    ..02). This finding was subsequently confirmed in alveolar epithelial cell scratch models. The potential relevance of these observations for lung inflammation and remodeling after mechanical injury is discussed...
  35. Lopez I, Aguilera Tejero E, Felsenfeld A, Estepa J, Rodriguez M. Direct effect of acute metabolic and respiratory acidosis on parathyroid hormone secretion in the dog. J Bone Miner Res. 2002;17:1691-700 pubmed
    Because both metabolic (Met Acid) and respiratory acidosis (Resp Acid) have diverse effects on mineral metabolism, it has been difficult to establish whether acidosis directly affects parathyroid hormone (PTH) secretion...
  36. McLaughlin M, Kassirer J. Rational treatment of acid-base disorders. Drugs. 1990;39:841-55 pubmed
    ..Treatment of respiratory acidosis should be targeted at restoring ventilation; alkali should be administered only for superimposed metabolic ..
  37. Joulia F, Steinberg J, Faucher M, Jamin T, Ulmer C, Kipson N, et al. Breath-hold training of humans reduces oxidative stress and blood acidosis after static and dynamic apnea. Respir Physiol Neurobiol. 2003;137:19-27 pubmed
    ..After dynamic apnea, the blood acidosis was reduced and the oxidative stress no more occurred. These results suggest that the practice of breath-holding improves the tolerance to hypoxemia independently from any genetic factor...
  38. Albright R, Friedman A, Fram E, Harbury O, Molter B, Skatoff J, et al. Comparison of [125I]HIPDm and [125I]iodoantipyrine in quantifying regional cerebral blood flow in rats. Stroke. 1988;19:1404-10 pubmed
    ....
  39. Budweiser S, Jörres R, Pfeifer M. Treatment of respiratory failure in COPD. Int J Chron Obstruct Pulmon Dis. 2008;3:605-18 pubmed
    ..and the duration of intensive care unit or hospital stays, particularly in the presence of mild to moderate respiratory acidosis. COPD with chronic hypercapnic respiratory failurebecame a major indication for domiciliary mechanical ..
  40. Niaki S, Shafaroodi H, Ghasemi M, Shakiba B, Fakhimi A, Dehpour A. Mouth breathing increases the pentylenetetrazole-induced seizure threshold in mice: a role for ATP-sensitive potassium channels. Epilepsy Behav. 2008;13:284-9 pubmed publisher
    Nasal obstruction and consequent mouth breathing have been shown to change the acid-base balance, producing respiratory acidosis. Additionally, there exists a large body of evidence maintaining that acidosis affects the activity of ATP-..
  41. Carroll G. Effect of alkalinization and fluids on survival in acute, non-hypoxic respiratory acidosis. Resuscitation. 1990;19:253-70 pubmed
    ..hypertonic saline, and Tromethamine were studied in 21 pigs and 60 rats subjected to acute, severe respiratory acidosis. Transient multiphasic alterations of systemic arterial pressures were seen with boluses of each agent-..
  42. Sahai A, Laughrey E, Tannen R. Relationship between intracellular pH and ammonia metabolism in LLC-PK1 cells. Am J Physiol. 1990;258:F103-8 pubmed
    ..Despite the absence of pH-responsive ammonia-genesis in still cultured cells the pHi values were altered in a fashion similar to their rocked counterparts, indicating the lack of an effect of the pHi signal on ammonia metabolism...
  43. Iizuka M, Fregosi R. Influence of hypercapnic acidosis and hypoxia on abdominal expiratory nerve activity in the rat. Respir Physiol Neurobiol. 2007;157:196-205 pubmed
    ..Thus, both hypercapnic acidosis and hypoxia activate abdominal muscle motoneurons in the absence of phasic afferent inputs...
  44. Pedersen D, Stefansson E, Kiilgaard J, Jensen P, Eysteinsson T, Bang K, et al. Optic nerve pH and PO2: the effects of carbonic anhydrase inhibition, and metabolic and respiratory acidosis. Acta Ophthalmol Scand. 2006;84:475-80 pubmed
    ..and compared how optic nerve pH (ONpH) and ONPO(2) are affected by: (1) carbonic anhydrase inhibition; (2) respiratory acidosis, and (3) metabolic acidosis...
  45. Broccard A. Respiratory acidosis and acute respiratory distress syndrome: time to trade in a bull market?. Crit Care Med. 2006;34:229-31 pubmed
  46. Emeis M, Sonntag J, Willam C, Strauss E, Walka M, Obladen M. Acidosis activates complement system in vitro. Mediators Inflamm. 1998;7:417-20 pubmed
    ..002). Respiratory acidosis activated C3a (p=0.007) and C5a (p=0.003) compared to normocapnic controls...
  47. Effros R, Su J, Casaburi R, Shaker R, Biller J, Dunning M. Utility of exhaled breath condensates in chronic obstructive pulmonary disease: a critical review. Curr Opin Pulm Med. 2005;11:135-9 pubmed
    ..Evaluation of the utility of exhaled breath condensates in chronic obstructive pulmonary disease...
  48. Boix J, Bataller A, Aznar O, Monferrer J, Kuret E, Gonzalez E, et al. [Acute respiratory failure in chronic obstructive lung disease. Effective weaning and excess base]. Rev Esp Anestesiol Reanim. 1994;41:332-5 pubmed
    ..When pH is kept within normal range by a high BE, the withdrawal of AMV, accompanied by either support system, is usually well-tolerated...
  49. Forster H, Murphy C, Brice A, Pan L, Lowry T. In vivo regulation of plasma [H+] in ponies during acute changes in PCO2. J Appl Physiol (1985). 1990;68:316-21 pubmed
    ..001) when Pco2 was increased from 25 to 55 Torr. A 3.5-meq/l decrease in [Cl-] (P less than 0.001) and a 1.3 +/- 0.1 meq/l increase in [Na+] (P less than 0.001) accounted for the SID change.(ABSTRACT TRUNCATED AT 250 WORDS)..
  50. Hampson N, Piantadosi C. Near-infrared optical responses in feline brain and skeletal muscle tissues during respiratory acid-base imbalance. Brain Res. 1990;519:249-54 pubmed
    ..These experiments demonstrate preferential distribution of oxygen to brain during hypercapnia and the ability of NIR spectroscopy to assess regional oxygenation in multiple tissues non-invasively...
  51. Costello J, Higgins B, Contreras M, Chonghaile M, Hassett P, O Toole D, et al. Hypercapnic acidosis attenuates shock and lung injury in early and prolonged systemic sepsis. Crit Care Med. 2009;37:2412-20 pubmed publisher
    ..In contrast, prolonged hypercapnia worsens pneumonia-induced lung injury. The effects of hypercapnia and acidosis in the setting of systemic sepsis remain to be determined...
  52. Kirksey K, Holt Ashley M, Goodroad B. An easy method for interpreting the results of arterial blood gas analysis. Crit Care Nurse. 2001;21:49-54 pubmed
    ..M.K.) has been using the H model for many years to teach students how to interpret the results of arterial blood gas analysis. The students are often amazed at how easy and fun the model makes learning a subject many perceive as complex...
  53. O Driscoll B, Howard L, Davison A. BTS guideline for emergency oxygen use in adult patients. Thorax. 2008;63 Suppl 6:vi1-68 pubmed publisher
  54. Krapf R. [Hypo- and hyperventilation: consequences for acid-base balance]. Schweiz Rundsch Med Prax. 1991;80:1058-61 pubmed
    ..hypocapnia and thus respiratory alkalosis whereas alveolar hypoventilation induces hypercapnia leading to respiratory acidosis. The changes in CO2 induce compensatory alterations of renal bicarbonate transport: Hypercapnia stimulates ..
  55. Novarini A. [Water-electrolyte and acid-base balance in surgery. Problems in the postoperative period]. Clin Ter. 1994;145:287-93 pubmed
    ..The identification and correction of these changes may avoid the onset of patterns due to reduced therapeutic surveillance...
  56. Elakkumanan L. The danger of oxygen therapy when pulmonary function is impaired. Acta Anaesthesiol Scand. 2008;52:1032-3 pubmed publisher
  57. Jankov R, Tanswell A. Hypercapnia and the neonate. Acta Paediatr. 2008;97:1502-9 pubmed publisher
    ....
  58. Akca O. Hypercapnia: what is the upper limit?. Paediatr Anaesth. 2005;15:80-1 pubmed
  59. Hryshchenko V. [Hemoglobin from newborn calves during artificial changes in the acid-base parameters of blood]. Ukr Biokhim Zh (1999). 1999;71:69-72 pubmed
    ..The investigated regularities revealed some aspects of adaptive mechanisms manifested during the abnormal exit of the newborn organism from the respiratory-metabolic acidosis state...
  60. Aschner J, Poland R. Sodium bicarbonate: basically useless therapy. Pediatrics. 2008;122:831-5 pubmed publisher
    ....
  61. Bushinsky D, Parker W, Alexander K, Krieger N. Metabolic, but not respiratory, acidosis increases bone PGE(2) levels and calcium release. Am J Physiol Renal Physiol. 2001;281:F1058-66 pubmed
    ..a reduction in bicarbonate concentration ([HCO(3)(-)]; metabolic acidosis) or to an increase in PCO(2) (respiratory acidosis)...
  62. Wood C, Munger R, Thompson J, Shuttleworth T. Control of rectal gland secretion by blood acid-base status in the intact dogfish shark (Squalus acanthias). Respir Physiol Neurobiol. 2007;156:220-8 pubmed
    ..treatments superimposed on the infusion caused the expected disturbances in systemic acid-base status: respiratory acidosis by exposure to high environmental PCO2, metabolic acidosis by infusion of HCl, and metabolic alkalosis by ..