Carbon Dioxide (CO2) Narcosis - Causes, Diagnosis and Impacts

Understand the reasons and health issues caused by CO2 Narcosis. Learn how to develop a healthy breathing and reducing our dependency on the oxygen. Read a case study which presents a case of CO2 Narcosis and the subsequent diagnosis.

CO2 narcosis happens when people are given too much oxygen. This slows down the oxygen-driven drive to breathe, and we breathe slower. Then CO2 can build up and reach levels that can be toxic and can be lethal, as in Hypercapnia. 

Oxygen bar usage and home oxygen concentrators could pose a problem for people with severe lung problems, but generally, it is not an issue. Pilots and astronauts should not have this problem unless they have advanced lung or neurological disease, which is highly unlikely but possible due to how science presently measures healthy breathing. 

A partial answer to this is to develop breathing and create less dependency on oxygen.

A case of emergency admission for CO2 narcosis in a patient with amyotrophic lateral sclerosis

A 68-year-old man with severe dyspnea was admitted as an emergency case. He had no past history of any respiratory or neuromuscular diseases. Immediately after insufflation of oxygen, respiratory arrest occurred. The blood gas analysis showed hypoxemia and severe hypercapnia (PaO2; 32 mmHg, PaCO2; 127 mmHg). 

We diagnosed as CO2 narcosis, and he was treated with a respirator in the ICU. He showed nonflaccid bilateral diaphragmatic paralysis and muscle atrophy of the upper extremities. As the EMG showed giant spikes of neurogenic pattern, he was diagnosed as ALS. Weaning from the respirator failed because of his respiratory muscle fatigue. 

He was given rehabilitation during the day time and ventilatory support with the respirator during the night. We conclude that if we meet with an emergency patient with CO2 narcosis without any pulmonary disorder, we have to suspect neuromuscular diseases, e.q. ALS. In some of such cases, mechanical ventilation supports social rehabilitation.