Hyperventilation: Difference between revisions

Jump to navigation Jump to search
Line 115: Line 115:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"|[[Acute stress disorder ]], [[Panic attack|Adult panic-anxiety syndrome]], [[agoraphobia]], [[anxiety ]], [[Briquet syndrome|Briquet's syndrome]], [[combat stress reaction ]], [[cree leukoencephalopathy ]], [[Stress (medicine)|Crying or severe distress]], [[Da Costa's syndrome|Da costa syndrome]], [[depression]], [[distress]], [[Excited state|excitement]], [[fear]], [[functional disorders]], [[grief]], [[hypochondriasis]], [[hysteria]], [[malingering]], [[pain]], [[panic attack ]], [[phobia]], [[primary habit disorder]], Rett's syndrome, [[schizophrenia]], [[stress]], strong emotions
|bgcolor="Beige"|[[Acute stress disorder ]], [[Panic attack|Adult panic-anxiety syndrome]], [[agoraphobia]], [[anxiety ]], [[Briquet syndrome|Briquet's syndrome]], [[combat stress reaction ]], [[cree leukoencephalopathy ]], [[Stress (medicine)|Crying or severe distress]], [[Da Costa's syndrome|Da costa syndrome]], [[depression]], [[distress]], [[Excited state|excitement]], [[fear]], [[functional disorders]], [[grief]], [[hypochondriasis]], [[hysteria]], [[malingering]], [[pain]], [[panic attack ]], [[phobia]], [[Stereotypic movement disorder|primary habit disorder]], Rett's syndrome, [[schizophrenia]], [[stress]], strong emotions
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"

Revision as of 15:32, 7 October 2015

Hyperventilation
ICD-10 R06.4
ICD-9 786.01
Tachypnea
ICD-10 R06.0
ICD-9 786.06

WikiDoc Resources for Hyperventilation

Articles

Most recent articles on Hyperventilation

Most cited articles on Hyperventilation

Review articles on Hyperventilation

Articles on Hyperventilation in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Hyperventilation

Images of Hyperventilation

Photos of Hyperventilation

Podcasts & MP3s on Hyperventilation

Videos on Hyperventilation

Evidence Based Medicine

Cochrane Collaboration on Hyperventilation

Bandolier on Hyperventilation

TRIP on Hyperventilation

Clinical Trials

Ongoing Trials on Hyperventilation at Clinical Trials.gov

Trial results on Hyperventilation

Clinical Trials on Hyperventilation at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Hyperventilation

NICE Guidance on Hyperventilation

NHS PRODIGY Guidance

FDA on Hyperventilation

CDC on Hyperventilation

Books

Books on Hyperventilation

News

Hyperventilation in the news

Be alerted to news on Hyperventilation

News trends on Hyperventilation

Commentary

Blogs on Hyperventilation

Definitions

Definitions of Hyperventilation

Patient Resources / Community

Patient resources on Hyperventilation

Discussion groups on Hyperventilation

Patient Handouts on Hyperventilation

Directions to Hospitals Treating Hyperventilation

Risk calculators and risk factors for Hyperventilation

Healthcare Provider Resources

Symptoms of Hyperventilation

Causes & Risk Factors for Hyperventilation

Diagnostic studies for Hyperventilation

Treatment of Hyperventilation

Continuing Medical Education (CME)

CME Programs on Hyperventilation

International

Hyperventilation en Espanol

Hyperventilation en Francais

Business

Hyperventilation in the Marketplace

Patents on Hyperventilation

Experimental / Informatics

List of terms related to Hyperventilation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview

In medicine, hyperventilation (or overbreathing) is the state of breathing faster and/or deeper than necessary, thereby reducing the carbon dioxide concentration of the blood below normal.[1]

This is in contrast to hyperpnea, where the increased breathing is required to meet demand, as during and following exercise or when the body lacks oxygen (hypoxia), for instance in high altitude or as a result of anaemia. Hyperpnea may also occur as a result of sepsis, and is usually a sign of the beginning of refractory sepsis.

Hyperventilation can, but does not necessarily cause symptoms such as numbness or tingling in the hands, feet and lips, lightheadedness, dizziness, headache, chest pain, slurred speech and sometimes fainting, particularly when accompanied by the Valsalva maneuver. Sometimes hyperventilation is induced for these same effects. Hyperventilation can sometimes be self induced for moments of needed focus and adrenaline.

The related symptom tachypnea (or "tachypnoea") (Greek: "rapid breathing") is characterized by rapid breathing and is not identical with hyperventilation - tachypnea may be necessary for a sufficient gas-exchange of the body, for example after exercise, in which case it is not hyperventilation.


Life-Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

  • Life threatening causes do not include chronic conditions.
  • Make sure to include the following definition underneath the subheading of every life threatening causes section: Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
  • The list of life threatening causes is arranged in alphabetical order.
  • If the page's disease is itself life-threatening, do not add causes in the life-threatening causes section. Instead, write the following sentence under the subheading: Disease name is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Cheyne-stokes respirations, congestive cardiac failure,pulmonary embolism, stroke
Chemical/Poisoning Ammonium chloride ,camphor ,glycol ether ,inhalation of irritants,methanol ,Salicylate poisoning,
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Aminophylline, aspirin, coffee abuse, pralidoxime, tiagabine
Ear Nose Throat No underlying causes
Endocrine Diabetic ketoacidosis, renal disease
Environmental Acute stress disorder
Gastroenterologic Abdominal surgery, acute liver failure, acute porphyria, end stage liver failure , hepatic cirrhosis, intestinal fistula, pyloric stenosis
Genetic Acute porphyria, arginosuccinic aciduria, carbamoylphosphate synthetase 1 deficiency disease, carbonic anhydrase va deficiency, hereditary fructose-1,6-bisphosphatase deficiency, Pitt-hopkins syndrome
Hematologic Acute porphyria
Iatrogenic No underlying causes
Infectious Disease CNS infection, fever
Musculoskeletal/Orthopedic Hip cancer
Neurologic Altitude sickness, acute, brain trauma, central neurogenic hyperventilation, cerebrovascular accident, CNS infection, cree leukoencephalopathy , damaged respiratory pathways, epilepsy, epileptic encephalopathy, early infantile, 2, head injury, intracranial space-occupying lesion, meningoencephalitis, pain, Pitt-hopkins syndrome, raised intracranial pressure, stroke, Vasovagal attacks
Nutritional/Metabolic Diabetic ketoacidosis, hereditary fructose-1,6-bisphosphatase deficiency, heat stroke, lactic acidosis
Obstetric/Gynecologic No underlying causes
Oncologic Bronchial neoplasm, rib tumor
Ophthalmologic No underlying causes
Overdose/Toxicity Biguanide intolerance
Psychiatric Acute stress disorder , Adult panic-anxiety syndrome, agoraphobia, anxiety , Briquet's syndrome, combat stress reaction , cree leukoencephalopathy , Crying or severe distress, Da costa syndrome, depression, distress, excitement, fear, functional disorders, grief, hypochondriasis, hysteria, malingering, pain, panic attack , phobia, primary habit disorder, Rett's syndrome, schizophrenia, stress, strong emotions
Pulmonary Acute altitude sickness, apneustic respirations, asthma, ataxic respiration, biot's respiration, central neurogenic hyperventilation, Cheyne-stokes respirations, damaged respiratory pathways, diffuse pulmonary fibrosis, emphysema , hypocapnia,hyperventilation syndrome, inhalation of irritants, lung damage

, metabolic acidosis , persistent hypoxemia, pleural effusion, pneumonia, pneumothorax, pulmonary embolism, pulmonary oedema

Renal/Electrolyte Acid-base imbalance , metabolic acidosis , phaeochromocytoma, renal disease
Rheumatology/Immunology/Allergy Asthma, pseudoallergic reactions
Sexual No underlying causes
Trauma Brain trauma, head injury, lung damage, raised intracranial pressure, sponatneous pneumothorax, stroke, surgical relocation of ureters in ileum or colon
Urologic No underlying causes
Miscellaneous Abdominal surgery, adulation, childbirth, fever

Causes in Alphabetical Order

The unnamed parameter 2= is no longer supported. Please see the documentation for {{columns-list}}.
3

Causes

Stress or anxiety commonly are causes of hyperventilation; this is known as hyperventilation syndrome.

Hyperventilation can also be brought about voluntarily, by taking many deep breaths. Hyperventilation can also occur as a consequence of various lung diseases, head injury, coffee abuse[2] or stroke (central neurogenic hyperventilation, apneustic respirations, ataxic respiration, Cheyne-Stokes respirations or Biot's respiration).

Lastly, in the case of metabolic acidosis, the body uses hyperventilation to counter the increased acidity of the blood; this is known as Kussmaul breathing.

Mechanism

In normal breathing, both the depth and frequency of breaths is varied by the neural system primarily in order to maintain normal amounts of carbon dioxide but also to supply appropriate levels of oxygen to the body's tissues. This is mainly done by measuring the carbon dioxide content of the blood; normally, a high carbon dioxide concentration signals a low oxygen concentration, as we breathe in oxygen and breathe out carbon dioxide at the same time, and the body's cells use oxygen to burn fuel molecules to carbon dioxide.

The gases in the alveoli of the lungs are nearly in equilibrium with the gases in the blood. Normally, less than 10% of the gas in the alveoli is replaced each breath. Deeper or quicker breaths exchange more of the alveolar gas with air and have the net effect of drawing more carbon dioxide out of the body, since the carbon dioxide concentration in normal air is very low.

The resulting low concentration of carbon dioxide in the blood is known as hypocapnia. Since carbon dioxide is held in the blood mostly in the form of carbonic acid, hypocapnia results in the blood becoming alkaline, i.e. the blood pH value rises. (In the normal person, this alkalosis would automatically be countered by reduced breathing, but for various reasons this doesn't happen when the neural control is not present.)

If carbon dioxide levels are high, the body assumes that oxygen levels are low, and accordingly the brain's blood vessels dilate, to assure sufficient blood flow and supply of oxygen. Conversely, low carbon dioxide levels (e.g. from hyperventilation) cause the brain's blood vessels to constrict, resulting in reduced blood flow to the brain and lightheadedness. Thus, though it seems counterintuitive, breathing too much can result in a decrease in the oxygen supply to the brain. Doctors sometimes artificially induce hyperventilation after head injury to reduce the pressure in the skull, though the treatment has potential risks.[3]

The high pH value resulting from hyperventilation also reduces the level of available calcium (hypocalcemia), which affects the nerves and causes the numbness or tingling of the hands. This occurs because alkalinisation of the plasma proteins (mainly albumin) increases their calcium affinity.

References

  1. Kenneth Baillie and Alistair Simpson. [ttp://www.altitude.org/calculators/oxygencalculator/oxygencalculator.htm "Hyperventilation calculator"]. Apex (Altitude Physiology EXpeditions). Retrieved 2006-08-10. - Online interactive oxygen delivery calculator that mimicks hyperventilation
  2. "Caffeine overdose in an adolescent male". J Toxicol Clin Toxicol. Retrieved 2006-08-14.
  3. Stocchetti N, Maas AI, Chieregato A, van der Plas AA (2005). "Hyperventilation in head injury: a review". Chest. 127 (5): 1812–27. doi:10.1378/chest.127.5.1812. PMID 15888864.

See also

Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs

Template:WH Template:WS