hypercapnia
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Introduction
Abnormally increased arterial carbon dioxide tension (pCO2).
Pathology
- hypercapnia without respiratory acidosis (compensated respiratory acidosis) is not associated with increased mortality in mechanically-ventilated patients with traumatic brain injury[2]
Physiology
- a normal response to hypercapnia is an increase in ventilation
Management
- increase ventilation by increasing respiratory rate &/or tidal volume
- avoid or minimize use of opioids
- opioids can cause severe respiratory depression by suppressing feedback mechanisms that increase ventilation in response to hypercapnia[3]
- paroxetine in combination with oxycodone further decreases ventilatory response to hypercapnia vs oxycodone alone[3]
- quetiapine in combination with oxycodone does not further decrease ventilatory response[3]
More general terms
Additional terms
References
- ↑ Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
- ↑ 2.0 2.1 Tiruvoipati R, Pilcher D, Botha J et al Association of Hypercapnia and Hypercapnic Acidosis With Clinical Outcomes in Mechanically Ventilated Patients With Cerebral Injury. JAMA Neurol. Published online March 19, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29554187 https://jamanetwork.com/journals/jamaneurology/fullarticle/2675293
Hemphill JC 3rd. Arterial Partial Pressure of Carbon Dioxide and Secondary Brain Injury - 6 Degrees of Separation? JAMA Neurol. Published online March 19, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29554181 https://jamanetwork.com/journals/jamaneurology/fullarticle/2675290 - ↑ 3.0 3.1 3.2 3.3 Florian J, van der Schrier R, Gershuny V et al Effect of Paroxetine or Quetiapine Combined With Oxycodone vs Oxycodone Alone on Ventilation During HypercapniaA Randomized Clinical Trial. JAMA. 2022;328(14):1405-1414. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36219407 https://jamanetwork.com/journals/jama/fullarticle/2797225