What is the role of ventilatory assistance in acute hypoventilation syndrome?

Updated: Jul 22, 2021
  • Author: Jazeela Fayyaz, DO; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Treatment of hypoventilation also is aimed at assisting ventilation. Therapies that may be beneficial are noninvasive ventilatory techniques, such as bilevel positive-pressure ventilation (PPV). Ventilatory assistance may be required in patients for the following indications:

  • Symptoms of nocturnal hypoventilation, such as daytime hypersomnolence, morning headaches, fatigue, nightmares, and enuresis

  • Dyspnea at rest

  • Hypoventilation that causes pulmonary hypertension and cor pulmonale

  • Nocturnal hypoxia (arterial oxygen saturation < 88%) despite supplemental oxygen

Patients with acute hypoventilation, diagnosed through symptoms and laboratory data, should be started on bilevel PPV urgently. If this fails to improve symptoms and laboratory data within a short period (1-2 h), consideration for intubation and invasive mechanical ventilation should be undertaken. Acute hypercapnia may progress to cardiovascular instability, arrhythmia, cardiac or respiratory arrest, and death if untreated.

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