Hyperventilation Syndromes

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

Acute hyperventilation

• Hyperpnea

• Paresthesias

• Carpopedal spasm

• Tetany

• Anxiety

Chronic hyperventilation presents nonspecifically

• Fatigue

• Dyspnea

• Anxiety

• Palpitations

• Dizziness

Symptoms must be reproduced during voluntary hyperventilation

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