Hypoventilation Treatment requires the correction of the disorders which are being underlined. To begin with the process it is suggested that caution should be taken while correcting hypercapnia. When there is rapid correction being done of the hypercapnia then it can alkalinize cerebrospinal fluid that can result into seizures and that can bring a metabolic alkalosis which in turn places the patient at a risk of getting cardiac dysrhythmias. But for chronic hypoventilation syndrome it is not indicated to infuse sodium HCO3.
- Bronchodilators like beta-agonists, anticholinergic agents and methylxanthines are helpful in treatment of patients who are having obstructive lung disease and bronchospasm. Furthermore, theophylline can make the contractility of the diaphragm muscle better and can stimulate the respiratory center.
- The aim of the Hypoventilation Treatment is to assist ventilation also. For this the therapies which will be good are endotracheal intubation with mechanical ventilation and the noninvasive ventilatory techniques like bilevel ventilation. This ventilatory support may be needed in the patients for the following signs:
- Signs of nocturnal hypoventilation like daytime hypersomnolence, fatigue, enuresis and nightmares.
- Dyspnea at rest
- Hypoventilation that results in pulmonary hypertension and cor pulmonale.
- Nocturnal hypoxia in spite of supplemental oxygen.
- The Noninvasive ventilation with the help of nocturnal positive-pressure ventilation (PPV) is largely acknowledged as the ventilatory form of choice in patients having chronic respiratory failure that is related to chronic obstructive pulmonary disease COPD in short, neuromuscular disease, idiopathic hypoventilation and thoracic deformities. Nocturnal PPV can prevent the requirement for tracheotomy and has made many patient-oriented outcomes much better. Bilevel positive-pressure ventilation is the favorite technique of noninvasive ventilation.
- The suggestions for noninvasive PPV for the nocturnal hypoventilation syndrome have been prepare on the basis of available literature. Patients those who are considered to be treated with this therapy have the following: a disease which is known to cause hypoventilation; symptoms of hypoventilation present; inability to react to first-line therapies in not so severe cases of hypoventilation; or moderate to a severe hypoventilation.
- The patients who have neuromuscular disorders that shows morning headache, sleep difficulties, daytime hypersomnolence or cognitive dysfunction for them the use of Nocturnal PPV is suggested.
- When the symptoms are not present then nocturnal PPV is suggested when the part pressure of alveolar carbon dioxide is bigger than 45 mm Hg or when the part pressure of arterial oxygen is lower than 60 mm Hg on morning blood gas measurement.
- The use of daytime ventilation should be made when the patients have PaCO2 greater than 50 mm Hg or saturation of oxygen less than 92%.
- Studies conducted with obesity hypoventilation syndrome patients have revealed that if there is a treatment for a year with nocturnal PPV then it improves blood gas values.
- Nocturnal hypoventilation works by improving nocturnal hypoventilation and also responsiveness of carbon dioxide.
- If the noninvasive ventilation is not able to give any benefit to the patients then it is better to consider undertaking intubation and invasive mechanical ventilation.