What causes hypoventilation?

Updated: Jul 22, 2021
  • Author: Jazeela Fayyaz, DO; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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The respiratory system serves a dual purpose: delivering oxygen to the pulmonary capillary bed from the environment and eliminating carbon dioxide from the bloodstream by removing it from the pulmonary capillary bed. Metabolic production of carbon dioxide occurs rapidly. Thus, a failure of ventilation promptly increases PaCO2.

Hypoventilation may be secondary to several mechanisms, including central respiratory drive depression, neuromuscular disorders, chest wall abnormalities, obesity hypoventilation, and COPD. The specific causes can be summarized as follows:

  • COPD

  • Neuromuscular disorders [3] - Amyotrophic lateral sclerosis, muscular dystrophies (Duchenne and Becker dystrophies), diaphragm paralysis, Guillain-Barré syndrome, myasthenia gravis

  • Chest wall deformities - Kyphoscoliosis, fibrothorax, thoracoplasty

  • Central respiratory drive depression - Drugs (narcotics, benzodiazepines, barbiturates), neurologic disorders (encephalitis, brainstem disease, trauma, poliomyelitis, multiple sclerosis), primary alveolar hypoventilation

  • Obesity-hypoventilation syndrome (OHS)

  • Carotid body resection and/or injury

  • Myxedema (severe hypothyroidism)

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