Interpretation of Arterial Blood Gases and Acid-Base Disorders

Posted by e-Medical PPT Sunday, July 18, 2010
Hypercapnia is when the partial pressure of carbon dioxide level goes above 45 mm Hg.Carbon dioxide is a gaseous product of the body's metabolism and is normally expelled through the lungs.Hypercapnia normally triggers a reflex which increases breathing and access to oxygen, such as arousal and turning the head during sleep. A failure of this reflex can be fatal, as in sudden infant death syndrome.
Hypercapnia is generally caused by hypoventilation, COPD,Neuromuscular disorders such as Guillain-Barre Syndrome, Botulism, Myasthenia Gravis, Polio, Stroke,Narcotic medications and Sleeping medications. It may also be caused by exposure to environments containing abnormally high concentrations of carbon dioxide (usually due to volcanic or geothermal causes), or by rebreathing exhaled carbon dioxide. It can also be an initial effect of administering supplemental oxygen on a patient with sleep apnea. In this situation the hypercapnia can also be accompanied by respiratory acidosis
Symptoms and signs of early hypercapnia include flushed skin, full pulse, tachypnea, dyspnoea, extrasystoles, muscle twitches,flapping tremor, reduced neural activity, and possibly a raised blood pressure. According to other sources, symptoms of mild hypercapnia might include headache, confusion and lethargy. Hypercapnia can induce increased cardiac output, an elevation in arterial blood pressure, and risk of arrhythmias.In severe hypercapnia symptomatology progresses to disorientation, panic, hyperventilation, convulsions, unconsciousness, and eventually death.

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