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Respiratory acidosis occurs when the arterial partial pressure of carbon dioxide (Pa CO2) is elevated above the normal range (>44 mm Hg) leading to a blood pH lower than 7.35.By definition, the diagnosis of respiratory acidosis requires measurement of Pa CO2 and pH. When the diagnosis is made, the underlying cause should be thoroughly investigated.
Acute vs chronic respiratory acidosis. Respiratory acidosis can be acute or chronic. In acute respiratory acidosis, the PaCO2 is elevated above the upper limit of the reference range (ie, >45 mm Hg) with an accompanying acidemia (ie, pH < 7.35).