Hypoventilation

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Hypoventilation
ICD-10 R06.8
DiseasesDB 29214
MeSH D007040

For patient information, click Hypoventilation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords:

Overview

In medicine, hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (hypo means "below") to perform needed gas exchange. It generally causes an increased concentration of carbon dioxide (hypercapnia) and respiratory acidosis. It can be caused by medical conditions, by holding one's breath, or by drugs, typically when taken in overdose. Hypoventilation may be dangerous for those with sleep apnea.

Classification

Pathophysiology

Hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (hypo meaning "below") to perform needed gas exchange. By definition it causes an increased concentration of carbon dioxide (hypercapnia) and respiratory acidosis.

Associated Conditions

  • Disorders like (CCHS) and Rapid-Onset Obesity, Hypothalamic Dysfunction, Hypoventilation, with Autonomic Dysregulation are recognized as conditions that are associated with hypoventilation. CCHS may be a significant factor in some cases of (SIDS), often termed "cot death" or "crib death".
  • The opposite condition is (too much ventilation), resulting in low carbon dioxide levels, rather than hypercapnia.

Causes

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Acetaminophen/Codeine Phosphate, Acetaminophen/Oxycodone Hydrochloride, Alcuronium, Alfentanyl, Alfentanil Hydrochloride, Alprostadil, Amobarbital sodium, Apomorphine, Aspirin/Caffeine/Dihydrocodeine Bitartrate, Aspirin/Codeine Phosphate, Aspirin/Oxycodone Hydrochloride, Atropine Sulfate, Baclofen, Brimonidine, Bupivacaine, Buprenorphine, Buprenorphine Hydrochloride, Buprenorphine/Naloxone, Butalbital/Acetaminophen/Caffeine/Codeine Phosphate, Butalbital/Aspirin/Caffeine/Codeine Phosphate, Butorphanol, Butorphanol Tartrate, Carisoprodol/Aspirin/Codeine Phosphate, Cifenline, Clobazam, Clonazepam, Clonidine, Codeine, Codeine Phosphate/Guaifenesin, Codeine Sulfate, Dantrolene, Desflurane, Dexmedetomidine, Dexmedetomidine Hydrochloride, Diazepam, Diclofenac, Dihydrocodeine, Disulfiram, Droperidol, Enflurane, Ethanol, Fentanyl, Fentanyl Citrate, Fentanyl/Droperidol, Halazepam, Homatropine Methylbromide/Hydrocodone Bitartrate, Hydrocodone, Hydrocodone Bitartrate, Hydrocodone Bitartrate/Acetaminophen, Hydrocodone Bitartrate/Chlorpheniramine Maleate, Hydrocodone Bitartrate/Guaifenesin, Hydrocodone Bitartrate/Ibuprofen, Hydrocodone Bitartrate/Pseudoephedrine Hydrochloride, Hydrocodone Polistirex/Chlorpheniramine Polistirex, Hydrocodone/Chlorpheniramine/Pseudoephedrine, Hydromorphone, Hydromorphone Hydrochloride, Ipratropium, Isoflurane, Ketamine, Ketamine Hydrochloride, Levorphanol, Levorphanol Tartrate, Lidocaine, Lopinavir/Ritonavir, Lorazepam, Magnesium, Meperidine, Meperidine Hydrochloride, Methadone, Methadone Hydrochloride, Methohexital, Methohexital Sodium, Midazolam, Midazolam Hydrochloride, Morphine, Morphine Sulfate, Morphine Sulfate Liposome, Morphine Sulfate/Naltrexone Hydrochloride, Nalbuphine, Nalbuphine Hydrochloride, Nefopam, Neostigmine, Nortriptyline, Onabotulinumtoxina, Opium, Oxaprozin, Oxycodone, Oxycodone Hydrochloride, Oxycodone Hydrochloride/Naloxone Hydrochloride, Oxycodon, Oxycodone Hydrochloride, Oxycodone Hydrochloride/Naloxone Hydrochloride, Oxycodone/Ibuprofen, Oxymorphone, Oxymorphone Hydrochloride, Paregoric, Pancuronium, Pancuronium Bromide, Pentazocine, Pentazocine Hydrochloride/Acetaminophen, Pentazocine Hydrochloride/Naloxone Hydrochloride, Pentazocine Lactate, Pentobarbital, Phenelzine, Polymixinb, Prilocaine, Prilocaine Hydrochloride, Promethazine, Promethazine Hydrochloride, Promethazine Hydrochloride/Codeine Phosphate, Promethazine/Phenylephrine/Codeine Phosphate, Propoxyphene, Propoxyphene Napsylate/Acetaminophen, Quinine, Remifentail, Remifentanil Hydrochloride, Riluzole, Rimabotulinumtoxinb, Secobarbital sodium, Sevoflurane, Sodium Oxybate, Succinylcholine, Succinylcholine Chloride, Sufentanil, Sufentanil Citrate, Tapentadol, Tapentadol Hydrochloride, Thiopental Sodium, Tilidine, Tramadol, Tramadol Hydrochloride, Tromethamine, Zanamivir
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Differentiating type page name here from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Treatment

Pharmacotherapy

  • Respiratory stimulants such as nikethamide were traditionally used to counteract respiratory depression from CNS depressant overdose, but were of only limited effectiveness.
  • A new respiratory stimulant drug called BIMU8 is being investigated which seems to be significantly more effective and may be useful for counteracting the respiratory depression produced by opiates and similar drugs without offsetting their therapeutic effects.
  • If the respiratory depression is from opioid overdose, then the overdose itself is usually treated with an inverse agonist, most likely naloxone, which will itself almost instantaneously stop the respiratory depression if caused by an opioid (and also, depending on the dose, plunge the patient into precipitated withdrawal).

References


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