Overview
Introduction
Hypoventilation is a failure of effective alveolar ventilation, so carbon dioxide accumulates even when the respiratory rate does not look dramatically abnormal.
Hypoventilation is a failure of effective alveolar ventilation, so carbon dioxide accumulates even when the respiratory rate does not look dramatically abnormal. The central nursing task is to distinguish chronic, compensated CO₂ retention from acute ventilatory failure and to identify why ventilation is inadequate. Obesity hypoventilation syndrome (OHS) is the main exam model: obesity, awake daytime hypercapnia, and no better neuromuscular, pulmonary, metabolic, or medication-related explanation. Obstructive sleep apnea commonly coexists, but OHS is defined by daytime hypercapnia rather than nocturnal obstruction alone. Stable patients need a planned PAP and weight-management strategy; patients who become acutely acidotic, confused, or unable to sustain ventilation need urgent ventilatory support.