Respiratory Insufficiency and [hidden till unmasked] Hypercapnia

Hidden hypercapnia is a bane to our existence. The word ‘bane‘ comes from Middle English, or possibly dates as far back as Old English. It comes from the word ‘bana’ which means ‘destroyer’ or ‘murderer. ‘ The use of the word ‘existence‘ refers to your life. Thus, the phrase ‘bane of my existence‘ literally means something that destroys your life. Dictionarykiwi.com › 2016/10/17 › what-is-the-origin-an..

Hypercapnia can destroy anyone’s life through loss of mind [reversible- if you hang on and do not die]. Hypercapnia will cause the sensation of anguish and distress [a form of dyspnea with or without visible shortness of breath] or mindless endogenous euphoria and endogenous intoxication.

Look up Hypercapnia in wikipedia.

Measuring respiratory rate during first episode or unmedicated serious mental illness, delirium or dementia or indeed any organ failure will alert you to this important issue in the blood. Investigating PCO2 , a measurement of Hypercapnia and unseen respiratory insufficiency, will alert you to the underlying reason for the deterioration of mind and behaviour. It will help to bring back normal mental status and normal behaviour and baseline personality.

Monitoring of PCO2 is not difficult and does not have to be invasive.

Monitoring of pCO2 during ventilation F S Magnet  1 , W Windisch  2 , J H Storre  PMID: 27048842 DOI: 10.1007/s00063-016-0150-3 2016 Apr;111(3):202-7. doi: 10.1007/s00063-016-0150-3. Epub 2016 Apr 5.

Abstract: Respiratory insufficiency type 2 (ventilatory failure) is characterized by hypercapnia due to alveolar hypoventilation. Therefore, the monitoring of pCO2 is essential for diagnostic and surveillance purposes. Various techniques which differ in the way of measurement (e.g., invasive/noninvasive, continuous/noncontinuous) and their indication are available. Arterial blood gas analysis (ABG) as an invasive procedure is the gold standard procedure and is mostly used in emergency medicine or intensive care units (ICUs). Another method to evaluate pCO2 is capillary blood gas analysis (CBG). Furthermore, endtidal pCO2-(PetCO2) and transcutaneous CO2-measurement (PtcCO2) are able to continuously and noninvasively monitor pCO2. PetCO2 is mostly used in the field of anesthesiology during general anesthesia and is integrated in many ventilators, also in ICUs. However, PetCO2 is limited in monitoring pCO2 in patients with lung disease and it is only reasonably usable in invasively ventilated patients. Transcutaneous pCO2 (PtcCO2) is available as an alternative, especially in chronic respiratory failure and to diagnose hypoventilation in sleep-related breathing disorders, and it has substantial advantages in these indications compared to discontinuous measurements, e.g., blood gas analysis. The various methods to monitor pCO2 are generally used synergistically in clinical practice.

Keywords: Acid–base balance; Blood gas analysis; Blood gas monitoring, transcutaneous; Lung diseases; Respiratory insufficiency.

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