hyperventilation syndrome
Introduction
Introduction to hyperventilation syndrome Hyperventilation syndrome is a physiological and psychological reaction caused by acute anxiety. When the attack occurs, the patient will feel heartbeat, palpitations, and sweating. Because he does not feel the breathing and accelerates the breathing, the carbon dioxide is continuously discharged and the concentration is too low, causing secondary hair. Sexual respiratory alkalosis and other symptoms. Excessive breathing is excessive breathing, causing respiratory alkalosis, causing numbness in the hands and feet. In severe cases, the limbs can be convulsions. basic knowledge The proportion of illness: 20% Susceptible people: no specific population Mode of infection: non-infectious Complications: respiratory alkalosis
Cause
Causes of hyperventilation syndrome
Mental hyperventilation
This is a common cause of respiratory alkalosis, but it is generally not serious. In severe cases, you may have dizziness, abnormal feelings, and occasional paralysis. Common in patients with rickets.
2. Metabolic process abnormalities
When the thyroid function is hyperthyroidism and fever, the ventilation can be significantly increased beyond the amount of CO2 that should be discharged. Can cause respiratory alkalosis, but generally not serious. However, it is indicated that the ventilation volume is not solely dependent on [H+] and Pco2 in body fluids, but also related to metabolic intensity and aerobic conditions. Excessive ventilation at this time may be caused by an increase in pulmonary blood flow through a reflective response.
3. Hypoxia hypoxia
Hyperventilation during hypoxic hypoxia is a compensation for hypoxia, but at the same time it can cause excessive CO2 excretion and respiratory alkalosis. Common in people who enter the plateau, mountains, or high altitude; patients with thoracic and pulmonary lesions such as pneumonia, pulmonary embolism, pneumothorax, and pulmonary congestion that cause thoracic, pulmonary, or pulmonary afferent nerve stimulation and increased reflex ventilation; In patients with congenital heart disease, hyperventilation can also occur due to increased right-to-left shunts resulting in hypotonic hypoxemia. These all cause a decrease in plasma H2CO3 and respiratory alkalosis.
4. Central nervous system disorders
Some of the patients with encephalitis, meningitis, brain tumors, cerebrovascular accidents, and craniocerebral injuries are stimulated and excited, and hyperventilation occurs.
5. Salicylic acidosis
Salicylic acid can directly stimulate the respiratory center to increase its excitability and increase sensitivity to normal stimuli. Thus hyperventilation occurs.
6. Gram-negative bacilli sepsis
In patients with Gram-negative bacilli entering the bloodstream, significant hyperventilation can occur when the body temperature and blood pressure have not changed. Pco2 has as low as 17mmHg. This change is very helpful for diagnosis. The mechanism is still unclear because this phenomenon was not successfully replicated in animal experiments.
7. Excessive artificial respiration.
8. Cirrhosis
Hyperventilation may occur in patients with cirrhosis with ascites and elevated blood NH3. May be caused by the stimulating effect of NH3 on the respiratory center. Of course, ascites lifts the diaphragm to stimulate breathing, but non-cirrhotic ascites patients do not have hyperventilatory reactions.
9. Metabolic acidosis is suddenly corrected
For example, using NaHCO3 to correct metabolic acidosis, the concentration of extracellular fluid [HCO3-] rapidly rises to normal, but the blood-brain barrier is very slow, about 12 to 24 hours. At this time, the brain is still metabolic acidosis, so hyperventilation Still persists. This results in a hypoxic respiratory alkalosis of H2CO3.
Pregnancy
There is a moderate increase in ventilation, which exceeds CO2 production. It is currently believed to be a stimulating effect of progesterone on the respiratory center, and some synthetic progesterone preparations also have this effect. During the pregnancy reaction period, ketoacidosis can occur due to vomiting and insufficient diet. Respiratory alkalosis can occur after the pregnancy reaction period, sometimes causing hand and foot spasms.
Prevention
Hyperventilation syndrome prevention
1. Appropriately vent your negative emotions, do not deliberately suppress.
2. Be aware of the initial symptoms of hyperventilation syndrome so as to remind yourself to relax your mood and slow down your breathing.
3. If excessive ventilation syndrome occurs again and again, appropriate psychological counseling should be sought.
4. To appease the patient's mood, and remind the patient to slow down and deepen the breathing. If it can be effectively done, usually within 5-10 minutes, the condition can be quickly eased.
5. You should avoid staying up late and caffeine stimulating drinks such as coffee and tea, as well as ecstasy and amphetamines.
Complication
Hyperventilation syndrome complications Complications, respiratory alkalosis
Hair and respiratory alkalosis.
Symptom
Symptoms of hyperventilation syndrome Common symptoms Hyperventilation consciousness disorder Hyperventilation Dizziness Chest chest pain Chest tightness Heart tachycardia Heart palpitations Hyperventilation causes syncope
The onset of the breathing is accelerated, the patient complains of breathing effort; chest tightness or suffocation, chest pain, palpitations, tachycardia, etc., limbs and facial numbness, hand and foot convulsions, muscle spasm and even rigidity, can also have headache, dizziness , consciousness disorder, physical examination without positive signs.
Examine
Examination of hyperventilation syndrome
Blood gas analysis PaCO2 decreased, pH increased, tachycardia, ECG can be found abnormal.
Diagnosis
Diagnosis and identification of hyperventilation syndrome
Diagnostic criteria
1. History, intrinsic to women, with neurosis or factors that induce mental stress.
2. Clinical manifestations.
3. Laboratory examination.
4. Test treatment, try to use carbon dioxide gas to inhale, can prevent the occurrence of symptoms.
Differential diagnosis
Epilepsy, hypothyroidism, hypoglycemia and other diseases.
