Hypercapnia in the context of Mechanical ventilation

An asphyxiant gas, also known as a simple asphyxiant, is a nontoxic or minimally toxic gas which reduces or displaces the normal oxygen concentration in breathing air. Breathing of oxygen-depleted air can lead to death by asphyxiation (suffocation). Because asphyxiant gases are relatively inert and odorless, their presence in high concentration may not be noticed, except in the case of carbon dioxide (hypercapnia).

Toxic gases, by contrast, cause death by other mechanisms, such as competing with oxygen on the cellular level (e.g. carbon monoxide) or directly damaging the respiratory system (e.g. phosgene). Far smaller quantities of these are deadly.

Dry ice is the solid form of carbon dioxide. It is commonly used for temporary refrigeration as CO₂ does not have a liquid state at normal atmospheric pressure and sublimes directly from the solid state to the gas state. It is used primarily as a cooling agent, but is also used in fog machines at theatres for dramatic effects. Its advantages include lower temperature than that of water ice and not leaving any residue (other than incidental frost from moisture in the atmosphere). It is useful for preserving frozen foods (such as ice cream) where mechanical cooling is unavailable.

Dry ice sublimes at 194.7 K (−78.5 °C; −109.2 °F) at Earth atmospheric pressure. This extreme cold makes the solid dangerous to handle without protection from frostbite injury. While generally not very toxic, the outgassing from it can cause hypercapnia (abnormally elevated carbon dioxide levels in the blood) due to a buildup in confined locations.

Peripheral chemoreceptors (of the carotid and aortic bodies) are so named because they are sensory extensions of the peripheral nervous system into blood vessels where they detect changes in chemical concentrations. As transducers of patterns of variability in the surrounding environment, carotid and aortic bodies count as chemosensors in a similar way as taste buds and photoreceptors. However, because carotid and aortic bodies detect variation within the body's internal organs, they are considered interoceptors. Taste buds, olfactory bulbs, photoreceptors, and other receptors associated with the five traditional sensory modalities, by contrast, are exteroceptors in that they respond to stimuli outside the body. The body also contains proprioceptors, which respond to the amount of stretch within the organ, usually muscle, that they occupy.

As for their particular function, peripheral chemoreceptors help maintain homeostasis in the cardiorespiratory system by monitoring concentrations of blood borne chemicals. These polymodal sensors respond to variations in a number of blood properties, including low oxygen (hypoxia), high carbon dioxide (hypercapnia), and low glucose (hypoglycemia). Hypoxia and hypercapnia are the most heavily studied and understood conditions detected by the peripheral chemoreceptors. Glucose is discussed in a later section. Afferent nerves carry signals back from the carotid and aortic bodies to the brainstem, which responds accordingly (e.g. increasing ventilation).

Obtundation is mild to moderate alertness reduction (altered level of consciousness) with decreased interest in the environment and slower than normal reactivity to stimulation. It is distinguished from the much stronger states of unresponsiveness of stupor and coma. Obtundation typically occurs as a result of a medical condition or trauma.

There is a wide range of potential causes including head injury, interruption of blood circulation, impaired oxygenation or carbon dioxide toxicity (hypercapnia); central nervous system (CNS) infections, drug intoxication or withdrawal, post-seizure state, hypothermia, and metabolic derangements such as hypoglycemia, hyponatremia, and hypercalcaemic crisis.

Hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (hypo meaning "below") to perform needed respiratory gas exchange. By definition it causes an increased concentration of carbon dioxide (hypercapnia) and respiratory acidosis. Hypoventilation is not synonymous with respiratory arrest, in which breathing ceases entirely and death occurs within minutes due to hypoxia and leads rapidly into complete anoxia, although both are medical emergencies. Hypoventilation can be considered a precursor to hypoxia, and its lethality is attributed to hypoxia with carbon dioxide toxicity.

Sleep apnea (sleep apnoea or sleep apnœa in British English) is a sleep-related breathing disorder in which repetitive pauses in breathing, periods of shallow breathing, or collapse of the upper airway during sleep results in poor ventilation and sleep disruption. Each pause in breathing can last for a few seconds to a few minutes and often occurs many times a night. A choking or snorting sound may occur as breathing resumes. Common symptoms include daytime sleepiness, snoring, and non-restorative sleep despite adequate sleep time. Because the disorder disrupts normal sleep, those affected may experience sleepiness or feel tired during the day. It is often a chronic condition.

Sleep apnea may be categorized as obstructive sleep apnea (OSA), in which breathing is interrupted by a blockage of air flow, central sleep apnea (CSA), in which regular unconscious breath simply stops, or a combination of the two. OSA is the most common form. OSA has four key contributors; these include a narrow, crowded, or collapsible upper airway, an ineffective pharyngeal dilator muscle function during sleep, airway narrowing during sleep, and unstable control of breathing (high loop gain). In CSA, the basic neurological controls for breathing rate malfunction and fail to give the signal to inhale, causing the individual to miss one or more cycles of breathing. If the pause in breathing is long enough, the percentage of oxygen in the circulation can drop to a lower than normal level (hypoxemia) and the concentration of carbon dioxide can build to a higher than normal level (hypercapnia). In turn, these conditions of hypoxia and hypercapnia will trigger additional effects on the body such as Cheyne–Stokes respiration.

Respiratory failure results from inadequate gas exchange by the respiratory system, meaning that the arterial oxygen, carbon dioxide, or both cannot be kept at normal levels. A drop in the oxygen carried in the blood is known as hypoxemia; a rise in arterial carbon dioxide levels is called hypercapnia. Respiratory failure is classified as either Type 1 or Type 2, based on whether there is a high carbon dioxide level, and can be acute or chronic. In clinical trials, the definition of respiratory failure usually includes increased respiratory rate, abnormal blood gases (hypoxemia, hypercapnia, or both), and evidence of increased work of breathing. Respiratory failure causes an altered state of consciousness due to ischemia in the brain.

The typical partial pressure reference values are oxygen Pa O
₂ more than 80 mmHg (11 kPa) and carbon dioxide Pa CO₂ less than 45 mmHg (6.0 kPa).

Hypocapnia (from the Greek words ὑπό meaning below normal and καπνός kapnós meaning smoke), also known as hypocarbia, sometimes incorrectly called acapnia, is a state of reduced carbon dioxide in the blood. Hypocapnia usually results from deep or rapid breathing, known as hyperventilation.

Hypocapnia is the opposite of hypercapnia.