Respiratory acidosis occurring alongside a severely reduced arterial pH — below the 7.2 threshold — represents a distinct and urgent clinical situation. The degree of acidemia at this level becomes a direct driver of management, beyond addressing the underlying cause alone.
This protocol applies to patients with respiratory acidosis whose arterial blood pH has fallen below 7.2 — a severity threshold at which the acidemia itself may require direct intervention. The specific pH level is central to the clinical decision point.
Management in this scenario may involve administration of an alkalinising agent to address the severity of the acidemia — though clinical guidance on its use at this threshold reflects an ongoing lack of universal consensus.
Complete regimen, decision criteria, and step-by-step algorithm available in the full protocol.
DOI: 10.1002/ncp.11328
For patients with severe acidemia (pH <7.2), sodium bicarbonate administration may be required, but there is no consensus about its use.
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