Respiratory compensation is the modulation by the brainstem respiratory centers, which involves altering alveolar ventilation to try to bring the plasma pH back to its normal value (7.4) in order to keep the acid-base balance in the body. It usually occurs within minutes to hours and is much faster than renal compensation (takes several days), but has less ability to restore normal values. In

metabolic acidosis Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidn ...

chemoreceptors A chemoreceptor, also known as chemosensor, is a specialized sensory receptor which transduces a chemical substance ( endogenous or induced) to generate a biological signal. This signal may be in the form of an action potential, if the chemorece ...

sense a changed acid-base balance with a plasma pH of lesser than normal (<7.4). The chemoreceptors send afferent fibers to the brainstem respiratory centers. The brainstem respiratory centers increase alveolar ventilation (

hyperventilation Hyperventilation is irregular breathing that occurs when the rate or tidal volume of breathing eliminates more carbon dioxide than the body can produce. This leads to hypocapnia, a reduced concentration of carbon dioxide dissolved in the blo ...

) so that

carbon dioxide Carbon dioxide is a chemical compound with the chemical formula . It is made up of molecules that each have one carbon atom covalent bond, covalently double bonded to two oxygen atoms. It is found in a gas state at room temperature and at norma ...

() can be breathed off, resulting in an increase of plasma pH. The amount of respiratory compensation in metabolic acidosis can be estimated using Winters' formula. Hyperventilation due to the compensation for metabolic acidosis persists for 24 to 48 hours after correction of the acidosis, and can lead to respiratory alkalosis. This compensation process can occur within minutes. In

metabolic alkalosis Metabolic alkalosis is an acid-base disorder in which the pH of tissue is elevated beyond the normal range (7.35–7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate (), or alternatively a dire ...

sense a deranged acid-base balance with a plasma pH of greater than normal (>7.4). The chemoreceptors send afferent fibers to the brainstem respiratory centers. The brainstem respiratory centers decrease alveolar ventilation (

hypoventilation Hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (''hypo'' meaning "below") to perform needed respiratory gas exchange. By definition it causes an increased concentration of carbon dioxide ( hypercap ...

) to create a rise in arterial

() tension, resulting in a decrease of plasma pH. However, as there is limitation for decreasing respiration, respiratory compensation is less efficient at compensating for metabolic alkalosis than for acidosis. The respiratory brainstem centers can only compensate for metabolic acid-base disturbances (

and

). Renal compensation is needed to balance respiratory acid-base syndromes (

respiratory acidosis The respiratory system (also respiratory apparatus, ventilatory system) is a biological system consisting of specific organs and structures used for gas exchange in animals and plants. The anatomy and physiology that make this happen varies gr ...

and

respiratory alkalosis Respiratory alkalosis is a medical condition in which Tachypnea, increased respiration elevates the blood pH beyond the normal range (7.35–7.45) with a concurrent reduction in arterial levels of carbon dioxide. This condition is one of the four ...

). The kidneys can compensate for both, respiratory and metabolic acid-base imbalances.

References

{{Renal physiology Acid–base disturbances