Hypercapnia: Mental Changes and Extrapulmonary Complications
Authors: MAURICIO J. DULFANO
Journal: Annals of Internal Medicine (1965)

Article1 November 1965Hypercapnia: Mental Changes and Extrapulmonary ComplicationsAn Expanded Concept of the "CO2 Intoxication" SyndromeMAURICIO J. DULFANO, M.D., SADAMU ISHIKAWA, M.D.MAURICIO J. DULFANO, M.D., SADAMU ISHIKAWA, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-5-829 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA frequent consultation to the Lung Station in a general hospital relates to patients suspected of having "CO2intoxication or narcosis." This diagnosis is commonly entertained when some mental or behavioral changes occur acutely in patients suffering from chronic obstructive pulmonary disease, especially during acute exacerbation of respiratory failure. The full blown picture of "CO2narcosis" in these patients is well known, particularly through the work of Westlake, Simpson, and Kaye (1) and Sieker and Hickam (2). However, attempts to estimate clinically the degree of carbon dioxide retention in terms of the degree of mental disturbance in any such patient...References1. WESTLAKESIMPSONKAYE EKTM: Carbon dioxide narcosis in emphysema. Quart. J. Med. 2: 155, 1955. Google Scholar2. SIEKERHICKAM HOJB: Carbon dioxide intoxication: clinical syndrome, its etiology and management, with particular reference to the use of mechanical respirators. Medicine 35: 389, 1956. CrossrefMedlineGoogle Scholar3. SCHWARTZBRACKETTCOHEN WBNCJJ: The response of extracellular hydrogen ion concentration to graded degrees of chronic hypercapnia; the physiologic limits of the defense of pH. J. Clin. Invest. 44: 291, 1965. CrossrefMedlineGoogle Scholar4. ROBIN ED: Abnormalities of acid-base regulation in chronic pulmonary disease, with special reference to hypercapnia and extracellular alkalosis. New Eng. J. Med. 268: 917, 1963. CrossrefMedlineGoogle Scholar5. DULFANOISHIKAWA MJS: Quantitative acid-base relationships in chronic pulmonary patients during the stable state. In preparation. Google Scholar6. BRACKETTCOHENSCHWARTZ NCJJWB: Carbon dioxide titration curve of normal man. Effects of increasing degrees of acute hypercapnia on acid-base equilibrium. New Eng. J. Med. 272: 6, 1965. CrossrefMedlineGoogle Scholar7. MILLERBADERBADER ARAME: The neurological syndrome due to marked hypercapnia, with papilledema. Amer. J. Med. 33: 309, 1962. CrossrefMedlineGoogle Scholar8. GROSSHAMILTON NJJD: Correlation between the physical signs of hypercapnia and the mixed venous pCO2. Brit. Med. J. 2: 1096, 1963. CrossrefMedlineGoogle Scholar9. HERZOGKOSTYAL HA: Disturbances of consciousness associated with respiratory insufficiency. German Med. Monthly 7: 361, 1962. Google Scholar10. CAMERON AJ: Marked papilledema in pulmonary emphysema. Brit. J. Ophthal. 17: 167, 1933. CrossrefMedlineGoogle Scholar11. SIMPSON T: Acute respiratory infections in emphysema. 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CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, MassachusettsFrom the Department of Medicine, Tufts University School of Medicine, and the Lung Station (Tufts), Boston City Hospital, Boston, Mass.Dr. Ishikawa is a Research Fellow in Medicine, Tufts University School of Medicine, Boston, Mass.Requests for reprints should be addressed to Mauricio J. Dulfano, M.D., Lung Station (Tufts), Boston City Hospital, 818 Harrison Avenue, Boston, Mass. 02118. 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LENNON, M.D., JACOB LEMANN JR., M.D.The Carbon Dioxide Response Curve for Chronic Hypercapnia in Man 1 November 1965Volume 63, Issue 5Page: 829-841KeywordsCarbon dioxideChronic obstructive pulmonary diseaseHemorrhageHospital medicineHypercapniaHypoxiaIntoxicationLungsPartial pressure of carbon dioxideRespiratory failure Issue Published: 1 November 1965 PDF DownloadLoading ...