What Is Hypoventilation?

Alveolar hypoventilation syndrome refers to a combination of hypoventilation due to a decrease in alveolar oxygen partial pressure and arterial blood oxygen partial pressure, and an increase in carbon dioxide partial pressure in arterial blood because the alveolar ventilation cannot meet the needs of tissue metabolism. Sign.

Alveolar hypoventilation syndrome

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Alveolar hypoventilation syndrome refers to a combination of hypoventilation due to a decrease in alveolar oxygen partial pressure and arterial blood oxygen partial pressure, and an increase in carbon dioxide partial pressure in arterial blood because the alveolar ventilation cannot meet the needs of tissue metabolism. Sign.

Alveolar hypoventilation syndrome (alveolar hypoventilation syndrome) means that the amount of alveolar ventilation cannot meet the needs of tissue metabolism. As a result, the partial pressure of oxygen in the alveoli and the partial pressure of blood in the arteries are reduced, and the partial pressure of carbon dioxide in the arteries is increased. But clinically meaningful hypoventilation syndrome, its PaCO2 is generally higher than 6.67kPa (50mmHg). Symptoms may vary depending on the degree of ventilation disorder. Indifference, dizziness, headache, fatigue, lethargy, and sweating may occur. In severe cases, optic disc edema, increased blood pressure, stress ulcers, cyanosis, pulmonary hypertension, pulmonary heart disease, etc . Active treatment of primary diseases is the main treatment of alveolar hypoventilation syndrome

Many clinical diseases can cause chronic alveolar hypoventilation, which are commonly seen in:

Respiratory sensory disease

Carotid body dysfunction and trauma, metabolic acidosis.

Brain stem disease

Pelvic medulla, cerebral infarction, intracranial neoplasms, demyelinating disease, long-term use of certain drugs (such as sedatives, anesthetics), and primary alveolar hypoventilation syndrome.

Spinal, peripheral and respiratory muscle disorders

Poliomyelitis, motor neuron disease, peripheral neuropathy, myasthenia gravis, muscle atrophy, chronic myopathy.

Thorax disease

Obesity-hypoventilation syndrome, scoliosis, etc. Lung and airway diseases: chronic obstructive pulmonary disease, cystic fibrosis, pharyngeal and tracheal obstruction, obstructive sleep apnea syndrome, etc.

Hypoventilation syndrome, although the underlying cause is not consistent, but its basic clinical characteristics are similar, that is, the alveolar and arterial blood PCO2 increase due to alveolar hypoventilation. There is an inverse correlation between alveolar PCO2 and PaO2. An increase in alveolar PCO2 will inevitably lead to a decrease in alveolar PO2, which will cause arterial hypoxemia. This typical pathophysiological change is more pronounced during nighttime sleep and when respiratory drive is further reduced.

The clinical manifestations of Alveolar Hypoventilation Syndrome have various primary symptoms and signs, and those with unknown causes are called primary alveolar hypoventilation syndrome. Symptoms may vary depending on the degree of ventilation disorder. Indifference, dizziness, headache, fatigue, drowsiness, and sweating may occur. In severe cases, optic disc edema, increased blood pressure, stress ulcers, cyanosis, pulmonary hypertension, pulmonary heart disease, etc. .

Alveolar hypoventilation syndrome can be complicated by pulmonary hypertension, pulmonary heart disease, and heart failure.

Blood gas analysis Arterial blood oxygen saturation saturation and arterial oxygen partial pressure decrease, while arterial blood carbon dioxide differentiation carbon partial pressure, hydrogen ion concentration, bicarbonate concentration, carbon dioxide binding carbon binding force are all increased , Hematocrit increased.

Pulmonary function tests show restricted or obstructive ventilation dysfunction.

Alveolar hypoventilation syndrome can be diagnosed based on clinical manifestations and physical signs in the laboratory.

Alveolar hypoventilation syndrome needs to be distinguished from pulmonary heart disease clinically.

1. The main measures of primary disease treatment for alveolar hypoventilation syndrome.

2. Respiratory stimulants are more suitable for sedatives or oxygen induced after taking oxygen.

3. Bronchodilators, hormones, and expectorants can be used to keep the airway open.

4. Oxygen therapy nasal cannula oxygen or positive pressure ventilator ventilation.

5. Correct acidosis For those with respiratory acidosis, especially those with mixed acidosis, tromethamine (THAM) can be used to correct it.

6. Carbonic anhydrase inhibitors, such as acetazolamide (acetazamide), can be used in chronic cases, but are contraindicated in the acute phase with carbon dioxide paralysis.

7. Symptomatic treatment of non-diaphragmatic or phrenic neuropathy can be used to pace the diaphragm, obese people should lose weight.

The prognosis of alveolar hypoventilation syndrome depends on the treatment of the primary disease.

Prevention of pulmonary alveolar hypoventilation syndrome should actively prevent lung infections, and those with heart failure should correct heart failure.

Oxygen, carbon dioxide, tromethamine, acetazolamide

Partial oxygen pressure, partial pressure of carbon dioxide, blood oxygen saturation, carbon dioxide binding force, hematocrit