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Medicine Respiratory 09b7ccfe

In ICU setting patients suffering from which respiratory pathology are at risk of CO2 narcosis?

A
Pneumonia
B
Asthma
C
Emphysema
D
Bronchieactasis
High-Yield Explanation
Ans. is 'c' i.e., Emphysema Metabolic causes of altered consciousness in ICU* In the ICU setting, several metabolic causes of an altered level of consciousness predominate.* Hypercarbic encephalopathy can present with headache, confusion, stupor, or coma.* Hypoventilation syndrome occurs most frequently in patients with a history of chronic CO2 retention who are receiving oxygen therapy for emphysema or chronic pulmonary disease.* The elevated Paco2 leading to CO2 narcosis may have a direct anesthetic effect, and cerebral vasodilation from increased PaCO2 can lead to increased ICP.* Hepatic encephalopathy is suggested by asterixis and can occur in chronic liver failure or acute fulminant hepatic failure.* Both hyperglycemia and hypoglycemia can cause encephalopathy, as can hypernatremia and hyponatremia.* Confusion, impairment of eye movements, and gait ataxia are the hallmarks of acute Wernicke's disease.

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