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For further information, see CMDT Part 9-38: Hyperventilation Syndromes

Key Features

  • Hyperventilation is an increase in alveolar minute ventilation leading to hypocapnia

  • Causes include

    • Pregnancy

    • Hypoxemia

    • Obstructive and infiltrative lung disease

    • Sepsis

    • Hepatic dysfunction

    • Fever

    • Pain

  • “Central neurogenic hyperventilation” describes monotonous, sustained deep breathing seen in comatose patients with brainstem injury

Clinical Findings

  • Acute hyperventilation

    • Hyperpnea

    • Paresthesias

    • Carpopedal spasm

    • Tetany

    • Anxiety

  • Chronic hyperventilation presents nonspecifically

    • Fatigue

    • Dyspnea

    • Anxiety

    • Palpitations

    • Dizziness

Diagnosis

  • Symptoms must be reproduced during voluntary hyperventilation

Treatment

  • When organic causes have been excluded, breathing through pursed lips or through the nose with one nostril pinched, or rebreathing expired gas from a paper bag decreases respiratory alkalemia and its symptoms

  • Anxiolytics may be helpful

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