Hypercapnia

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Obesity, Sleep & Internal medicine
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Hypercapnia
Synonyms	Hypercarbia, CO2 retention
Pronounce	N/A
Specialty	N/A
Symptoms	Headache, confusion, lethargy, flushed skin, tachypnea, dyspnea, increased blood pressure
Complications	Respiratory acidosis, coma, seizures
Onset	Sudden or gradual
Duration	Variable
Types	N/A
Causes	Hypoventilation, lung disease, obesity hypoventilation syndrome, neuromuscular disorders
Risks	Chronic obstructive pulmonary disease, obesity, sedative use
Diagnosis	Arterial blood gas, capnography
Differential diagnosis	Metabolic acidosis, respiratory alkalosis
Prevention	Ventilation support, weight loss, smoking cessation
Treatment	Non-invasive ventilation, oxygen therapy, bronchodilators
Medication	N/A
Prognosis	Depends on underlying cause and treatment
Frequency	Common in chronic lung disease
Deaths	N/A

Hypercapnia, also known as hypercarbia, is a medical condition characterized by an excessive amount of carbon dioxide (CO2) in the bloodstream. It is most often associated with respiratory conditions that inhibit proper lung function, leading to insufficient gas exchange and subsequent buildup of CO2.

Pathophysiology

Hypercapnia occurs when the body's respiratory system fails to remove sufficient carbon dioxide during respiration. This can be due to conditions that affect lung function such as chronic obstructive pulmonary disease (COPD), pneumonia, and asthma, as well as conditions that impair the control of respiration like certain neurological diseases. In the bloodstream, carbon dioxide is primarily carried in the form of bicarbonate. An increase in CO2 concentration shifts the body’s pH balance towards acidosis, which can impair enzyme function and cellular processes.

Clinical Manifestations

Symptoms of hypercapnia can vary depending on the severity and rate of onset. They may include shortness of breath, lethargy, confusion, and in severe cases, can lead to respiratory failure or even loss of consciousness. Chronic hypercapnia can often be tolerated better than acute hypercapnia as the body adapts to the elevated CO2 levels.

Diagnosis and Management

Hypercapnia is typically diagnosed through arterial blood gas (ABG) analysis, which measures the partial pressures of oxygen and carbon dioxide in arterial blood. The management of hypercapnia involves treating the underlying cause. This might involve supplemental oxygen, medications to improve lung function in diseases like COPD, or in severe cases, mechanical ventilation.

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References

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1. "Hypercapnia: Clinical Relevance and Mechanisms of Action." Current Opinion in Critical Care. Journal article - Current Opinion in Critical Care
2. "Hypercapnia." StatPearls. StatPearls
3. "The Physiological Consequences of Hypercapnia." Critical Care. Biomedcentral