Respiratory compensation

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Respiratory compensation
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Altered breathing pattern, dyspnea
Complications	Respiratory alkalosis, respiratory acidosis
Onset	Acute or chronic
Duration	Variable, depending on underlying cause
Types	N/A
Causes	Metabolic acidosis, metabolic alkalosis
Risks	N/A
Diagnosis	Arterial blood gas analysis, serum bicarbonate levels
Differential diagnosis	Metabolic compensation, mixed acid-base disorders
Prevention	N/A
Treatment	Address underlying cause, ventilatory support if needed
Medication	N/A
Prognosis	Depends on underlying condition
Frequency	Common in patients with chronic kidney disease, diabetes mellitus
Deaths	N/A

Respiratory compensation is a mechanism by which the body adjusts the respiratory rate to change the blood pH. This process is part of the body's acid-base homeostasis and involves the respiratory system and the kidneys.

Introduction

Respiratory compensation is a response to metabolic acidosis or metabolic alkalosis. In metabolic acidosis, the body increases the respiratory rate to expel more carbon dioxide and increase the blood pH. In metabolic alkalosis, the body decreases the respiratory rate to retain more carbon dioxide and decrease the blood pH.

Mechanism

The central nervous system (CNS) controls the respiratory rate based on the level of carbon dioxide in the blood. The chemoreceptors in the medulla oblongata and the carotid bodies detect changes in the blood pH and send signals to the CNS to adjust the respiratory rate. In metabolic acidosis, the blood pH is low due to an excess of hydrogen ions. The body responds by increasing the respiratory rate to expel more carbon dioxide, which is an acid. This reduces the amount of carbonic acid in the blood and increases the blood pH. In metabolic alkalosis, the blood pH is high due to a deficiency of hydrogen ions. The body responds by decreasing the respiratory rate to retain more carbon dioxide. This increases the amount of carbonic acid in the blood and decreases the blood pH.

Clinical significance

Respiratory compensation is a critical mechanism in the management of acid-base disorders. It can help to partially correct the pH imbalance in metabolic acidosis or metabolic alkalosis. However, it cannot fully correct the imbalance, and the underlying cause of the disorder must be treated. Respiratory compensation can also occur in response to respiratory acidosis or respiratory alkalosis. However, in these cases, the compensation is performed by the kidneys, which adjust the excretion of hydrogen ions and bicarbonate ions.

See also

• Acid-base homeostasis
• Respiratory system
• Kidneys
• Metabolic acidosis
• Metabolic alkalosis
• Respiratory acidosis
• Respiratory alkalosis