Disorders of Ventilation

ALVEOLAR HYPOVENTILATION

  • When there is alveolar hypoventilation, arterial PC02 increases above the range of 37 – 43 mmHg.
  • PaC02 may be 50 – 80 mmHg.
  • The respiratory system is dependent upon a complex system of ventilatory control to ensure appropriate and adequate ventilation in order to supply oxygen, remove carbon dioxide, and maintain acid-base homeostasis.
Disorders of Ventilation

Disorders of Ventilation Causes Clinical Features Treatment

CHRONIC HYPOVENTILATION Etiologic   :

  • · Obesity
  • · COPD
  • · Myasthenia gravis
  • · Motor neuron disease
  • · Poliomyelitis
  • · Brain stem infarction and haemorrhage
  • · Metabolic alkalosis
  • · High cervical hauma
  • · Obstructive sleep apnea
  • · Cystic fibrosis
  • · Kyphoscoliosis.

Clinical Features of Disorders of Ventilation :

  • · Cyanosis
  • · Secondary polycythemia
  • · Pulmonary hypertension
  • · RVH (Right Ventricular Hypertrophy)
  • · CHF (Congestive Heart Failure)
  • · Morning headache
  • · Fatigue
  • · Somnolence
  • · Mental confusion
  • ·Intellectual impairment.

Treatment of Disorders of Ventilation

  • Treat the cause
  • Correction of metabolic acidosis Supplemental oxygen Progesterone may be of benefit Mechanical ventilatory support Diaphragmatic pacing
  • Bipap ventilation – non-invasive positive pres­sure ventilation.

HYPOVENTILATION SYNDROMES Primary alveolar hypoventilation

  • · It is a disorder of unknown cause
  • · There is chronic hypercapnia and hypoxaemia
  • · There is no neuromuscular disease.

Respiratory neuromuscular disorders

  • · Disease of spinal cord, peripheral respiratory nerves and disease of respiratory muscles pro­duce a chronic hypoventilation syndrome over a • period of months to years e.g. MND (Motor Neu­ron Disease), myasthenia gravis, muscular dystrophy.

Obesity hypoventilation syndrome

  •  Massive obesity causes a load on the respiratory system due to weight on the rib cage and abdo­men reducing the compliance of the chest wall.
  • Treatment is reduction of weight, cessation of smoking in smokers, treatment of sleep apnea, enhancement of respiratory drive by progesterone.

HYPERVENTILATION AND ITS SYNDROMES

  • Alveolar hyperventilation is PaC02 below range of 37­.- 43 mmHg.

Causes are Disorders of Ventilation :

  • High altitude
  • Pulmonary disease – Cardiac shunts
  • – Chest wall disorder
  • – CHF
  • Diabetic acidosis ./ Hepatic failure ../ Psychogenic
  • Salicylate induced ‘IT Fever
  • Sepsis
  • Pain
  • Pregnancy.
  • Treatment is removal of underlying cause. Usually alveolar hyperventilation has no clinical consequence and may not require treatment.

DOWNLOAD OUR ANDROID APP

One of the 1st in India.High Quality Generic Medicine Portal Android Application for Online Oreder & Information.

For More Join Our Membership and Get Additional 25% off on Meds, also get MLM Benefits to get a permanent earning source.

Join Membership How to Search Medicine
Android App

We would like to keep you updated with special notifications.