Hypercapnia Totally Explained

Everything about Carbon Dioxide Poisoning totally explained

Hypercapnia or hypercapnea (from the Greek hyper = "above" and kapnos = "smoke"), also known as hypercarbia, is a condition where there's too much carbon dioxide (CO₂) in the blood. Carbon dioxide is a gaseous product of the body's metabolism and is normally expelled through the lungs.
Hypercapnia is the opposite of hypocapnia.

Causes

Hypercapnia is generally caused by hypoventilation, lung disease, or diminished consciousness. It may also be caused by exposure to environments containing abnormally high concentrations of carbon dioxide (usually due to volcanic or geothermal causes), or by rebreathing exhaled carbon dioxide. It can also be an initial effect of administering supplemental oxygen on a patient with sleep apnea. In this situation the hypercapnia can also be accompanied by respiratory acidosis.

Symptoms

Symptoms of early hypercapnia, where arterial carbon dioxide pressure, PaCO₂, is elevated but not extremely so, include flushed skin, full pulse, extrasystoles, muscle twitches, hand flaps, reduced neural activity, and possibly a raised blood pressure. In severe hypercapnia (generally PaCO₂ greater than 10 kPa or 75 mmHg), symptomatology progresses to disorientation, panic, hyperventilation, convulsions, unconsciousness, and eventually death.

Laboratory Values

Hypercapnia is generally defined as a blood gas carbon dioxide level over 45 mmHg. Since carbon dioxide is in equilibrium with bicarbonate in the blood, hypercapnia can also result in a high serum bicarbonate (HCO₃^-) concentration. Normal bicarbonate concentrations vary from 22 to 28 milligrams per deciliter.

During diving

Reasons

There are a variety of reasons for carbon dioxide not being expelled completely when the diver exhales:

The diver is exhaling into a vessel that doesn't allow all the CO₂ to escape to the environment, such as a long snorkel, full face diving mask, or diving helmet. The diver then re-inhales from that vessel.
The carbon dioxide scrubber in the diver's rebreather is failing to remove sufficient carbon dioxide from the loop.
The diver is over-exercising, producing excess carbon dioxide due to elevated metabolic activity.
The density of the breathing gas is higher at depth, so the effort required to fully inhale and exhale has increased, making breathing more difficult and less efficient. The higher gas density also causes gas mixing within the lung to be less efficient, thus increasing the deadspace (wasted breathing).
The diver is deliberately hypoventilating, known as "skip breathing" (see below).

Skip breathing

Skip breathing is a controversial technique to conserve breathing gas when using open-circuit scuba, which consists of briefly holding one's breath between inhalation and exhalation (for example "skipping" a breath). It leads to CO₂ not being exhaled efficiently. There is also an increased risk of burst lung from holding the breath while ascending.
Skip breathing is counter productive with a rebreather where the act of breathing pumps the gas around the "loop" pushing carbon dioxide through the scrubber and mixing freshly injected oxygen.

Rebreathers

In closed circuit SCUBA (rebreather) diving, exhaled carbon dioxide must be removed from the breathing system, usually by a scrubber containing a solid chemical compound with a high affinity for CO₂, such as soda lime. If not removed from the system, it may be re-inhaled, causing an increase in the inhaled concentration.

Further Information

Get more info on 'Carbon Dioxide Poisoning'.

External Link Exchanges

Do you know how hard it is to get a link from a large encyclopaedia? Well we're different and will prove it. To get a link from us just add the following HTML to your site on a relevant page:

<a href="http://hypercapnia.totallyexplained.com">Hypercapnia Totally Explained</a>

Then simply click through this link from your web page. Our crawlers will verify your link, extract the title of your web page and instantly add a link back to it. If you like you can remove the words Totally Explained and embed the link in article text.
As long as your link remains in place, we'll keep our link to you right here. Please play fair - our crawlers are watching. Your site must be closely related to this one's topic. Any kind of spamming, dubious practises or removing the link will result in your link from us being dropped and, potentially, your whole site being banned.