Respiratory suppressive medications, e.g.:.(1) respiratory drive problem (“won't breathe”) Another example is that of a patient with chronic hypercapnia due to COPD, who may experience worsening hypercapnia due to any deterioration in lung function (e.g., pneumonia or cardiogenic pulmonary edema). For example, hypercapnia in asthma is generally due to a combination of bronchospasm and diaphragmatic muscle fatigue. A patient with substantial hypercapnia may have several factors promoting this simultaneously. This prevents the bicarbonate level from being an accurate arbiter of whether the hypercapnia is acute or chronic (figure below).īelow are various potential causes of hypercapnia. ⚠️ In reality, there are often many other factors which can also affect the bicarbonate level.(2) There are no other factors affecting the bicarbonate level (i.e., no metabolic acidosis or metabolic alkalosis).However, this analysis assumes the following:.In chronic hypercapnia, there will be a greater degree of compensatory metabolic alkalosis. The patient's baseline bicarbonate level may help determine whether hypercapnia is acute or chronic (table above, right side).(2) Primary hypercapnia is hypercapnia that isn't a compensatory response to metabolic alkalosis.Hypercapnia may also be diagnosed from a venous blood gas (more on comparing VBG vs. (1) Hypercapnia is defined as PaCO2 >45 mm.
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