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CARBON DIOXIDE INTOXICATION: THE CLINICAL SYNDROME, ITS ETIOLOGY AND MANAGEMENT WITH PARTICULAR REFERENCE TO THE USE OF MECHANICAL RESPIRATORS

HERBERT O. SIEKER; JOHN B. HICKAM
Arch Intern Med. 1971;127(4):637-670. doi:10.1001/archinte.1971.00310160115010.
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INTRODUCTION  Carbon dioxide intoxication is now recognized as a syndrome that can occur in persons with disorders which greatly reduce alveolar ventilation (3, 7, 13, 14, 33, 37, 42, 61, 63, 70, 79). The symptoms and clinical findings in this condition vary in character and severity and may simulate other disease entities. With moderate acidosis and hypercapnia, the patient may have no complaints, or the only symptoms noted may be weakness, lassitude, irritability, mild confusion, or headache. More severe respiratory acidosis can cause carbon dioxide narcosis with coma, respiratory depression and circulatory failure. Frequently, severe or prolonged narcosis results in the death of the patient.Retention of carbon dioxide is most commonly observed in individuals with chronic lung disease which results in impaired ventilation, particularly obstructive emphysema and pulmonary fibrosis. On this background carbon dioxide intoxication can develop when ventilation becomes mechanically more difficult; e.g., with a respiratory infection (67,

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