Hypercapnia: Causes, Treatments, And Diagnosis

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Human Biology

What to know about hypercapnia (hypercarbia)

Medically reviewed by Megan Soliman, MD — Written by Jayne Leonard — Updated on December 23, 2024

Overview
Symptoms
Causes
Diagnosis
Treatment
Prevention
FAQ
Summary

Hypercapnia, also called hypercarbia, arises from having too much carbon dioxide in the blood. It typically happens with hypoxia, which is when there is not enough oxygen in the body.

This article discusses symptoms and causes of hypercapnia and outlines some treatment options.

What is hypercapnia?

Hypercapnia happens when breathing problems make it difficult to take in oxygen and breathe out carbon dioxide. It is typically due to a disease that affects the lungs.

Symptoms can range from mild to severe, and can include fatigue, headache, and confusion.

Possible causes include the respiratory conditions chronic obstructive pulmonary disease (COPD) and asthma.

What are the symptoms of hypercapnia?

Symptoms can be acute, meaning they start suddenly and last a short while. Or they can be chronic, meaning they last a long time. People with chronic hypercapnia may also experience a temporary worsening of symptoms.

Symptoms can range from mild to severe.

Mild symptoms

A person with hypercapnia might notice:

fatigue
headache
flushed skin
shortness of breath
nausea
irritability

These symptoms may arise from shorter periods of shallow or slow breathing, such as during deep sleep.

The body can often balance carbon dioxide levels in the bloodstream and correct the symptoms by itself. However, if symptoms persist, a person should contact a doctor.

Severe symptoms

The symptoms of severe hypercapnia require immediate medical attention, as they can cause long-term complications. Some may even be fatal.

Severe hypercapnia symptoms include:

confusion
depression or paranoia
anxiety
nausea and vomiting
seizure
fainting
loss of consciousness or coma
panic attack
arrhythmia
cardiovascular breakdown

A person may also experience other symptoms related to an underlying disease such as COPD or asthma.

What are the causes and risk factors of hypercapnia?

Here are some possible causes of hypercapnia.

COPD

COPD is an umbrella term for several conditions that affect breathing. Common forms of COPD include chronic bronchitis and emphysema.

Chronic bronchitis leads to inflammation and mucus in the airways, while emphysema involves damage to the alveoli (air sacs) in the lungs.

Both conditions can cause increased levels of carbon dioxide in the bloodstream.

The main cause of COPD is long-term exposure to lung irritants. According to the National Heart, Lung, and Blood Institute, cigarette smoke is the most common lung irritant that causes COPD in the United States.

However, up to 30% of people with COPD have never smoked. Some have a genetic condition in which the liver does not produce enough alpha-1-antitrypsin (AAT). AAT is a protein that supports lung health. Having an AAT deficiency is a risk factor for COPD development.

Air pollution and exposure to chemicals or dust may also cause COPD.

Although not everyone with COPD will develop hypercapnia, a person’s risk increases as their COPD progresses.

Which breathing exercises can help with COPD?

Asthma

Asthma causes the airways to become inflamed and narrowed. It may impact breathing and the levels of carbon dioxide in the body when it is unmanaged.

People with asthma have a higher risk of hypercapnia.

Doctors do not know precisely why asthma develops, though it is likely due to a combination of genetic and environmental factors. Activities that can trigger an asthma attack include exercise and exposure to irritants, including cigarette smoke and air pollution.

How can yoga help manage asthma?

Sleep apnea

Sleep apnea can present as shallow breathing or pauses in breathing during sleep. It can affect oxygen levels in the blood and the body’s balance of carbon dioxide and oxygen.

Sleep apnea symptoms include:

daytime sleepiness
headache upon waking
difficulty concentrating
snoring

Can surgery help with sleep apnea?

Nerve disorders and muscular problems

In some people, the nerves and muscles necessary for sufficient lung function may not work correctly. For example, muscular dystrophy can cause the muscles to weaken, eventually leading to breathing problems.

Other disorders of the nervous or muscular systems that can contribute to hypercapnia include the following:

amyotrophic lateral sclerosis, which affects nerve cells in the brain and spinal cord
encephalitis, which is inflammation of the brain
Guillain-Barré syndrome, which can result from an unusual immune response
myasthenia gravis, which is a chronic disease that can weaken the skeletal muscles responsible for breathing

Other causes

Other causes of high blood levels of carbon dioxide include:

activities that impact breathing, including diving and ventilator use
COVID-19 in some people who use a ventilator
brain stem stroke, which can affect breathing
hypothermia, which is severe heat loss from the body that often occurs with hypercapnia and hypoxia
obesity hypoventilation, which happens when having obesity makes it difficult to breathe deeply or quickly enough, according to a 2021 paper

drugs that can slow breathing, such as opioids

Does wearing a face mask cause hypercapnia?

During the COVID-19 pandemic, some people had concerns that wearing a face mask could lead to hypercapnia. However, there is very little evidence to support this.

Face masks are not airtight. The materials allow air, including carbon dioxide, to circulate rather than build up. Even with medical-grade masks, it is unlikely that significant levels will build up with short-term use.

Additionally, thinner surgical and cloth masks are more porous and loose-fitting, allowing for even more air exchange.

People who have difficulty breathing do not need to wear a face mask.

How do doctors diagnose hypercapnia?

Some tests used to diagnose hypercapnia include:

Blood tests: Laboratory tests can check for anemia and assess sodium, potassium, and chloride levels.
Thyroid stimulating hormone: Doctors use this hormone to test for thyroid problems.
Arterial blood gas test: This measures the blood levels of carbon dioxide and oxygen.
Spirometry test: This test involves blowing into a tube to assess how much air a person can move out of their lungs and how fast they can do it.
X-ray or CT scan: These imaging tests can show the presence of lung damage and lung conditions.

What are the treatment options for hypercapnia?

The treatment for hypercapnia will depend on the severity of the condition and the underlying cause. Options include:

Ventilation

Ventilation is typically the first line of treatment for hypercapnia. A doctor may use:

Noninvasive ventilation: Airflow comes through a mouthpiece or nasal mask. This is helpful for people with sleep apnea to keep their airways open at night. It is also known as continuous positive airway pressure, or CPAP.
Mechanical ventilation: A doctor will insert a tube through the mouth into the airway. This is called intubation.

People with severe hypercapnia symptoms may need a ventilation device to help them breathe.

Medication

Certain medications can help manage breathing or address underlying problems:

antibiotics can treat pneumonia or other respiratory infections
bronchodilators can open the airways
corticosteroids can reduce inflammation in the airway

Oxygen therapy

People who undergo oxygen therapy regularly use a device to deliver oxygen to the lungs. Oxygen therapy can help balance the levels of carbon dioxide in the blood.

Lifestyle changes

To reduce symptoms and avoid complications, a doctor may recommend:

dietary changes
increased physical activity
quitting or avoiding smoking
limiting exposure to chemicals, dust, and fumes, where possible

Surgery

Some people with lung or airway damage need surgery. Lung volume reduction surgery can remove damaged tissue. With lung transplantation, a surgeon replaces a damaged lung with a healthy lung from a donor.

Can a person prevent or lower their risk of hypercapnia?

Methods for helping to prevent hypercapnia include:

treating existing lung conditions
quitting or avoiding smoking
reaching or maintaining a moderate weight
following an exercise plan
avoiding exposure to toxic fumes and chemicals

Frequently asked questions

Here are some answers to questions people often ask about hypercapnia.

What is hypercapnia?

Hypercapnia, also called hypercarbia, is when there is too much carbon dioxide in the blood. It happens when not enough carbon dioxide leaves the lungs. Typically, at the same time, there is not enough oxygen entering the lungs.

Can hypercapnia be reversed?

It is possible for a person to reverse hypercapnia, but the likelihood of this depends on the cause of the condition and how early a person receives a diagnosis.

Can hypercapnia cause a stroke?

Hypercapnia can cause a stroke. It can raise intracranial pressure which can reduce or alter the blood flow to certain parts of the brain, raising a person’s risk of stroke.

How long can a person live with hypercapnia?

The outlook for hypercapnia will depend on a person’s individual circumstances. These include how early they received a diagnosis, what had caused the hypercapnia, and their overall health.

What causes hypercapnia?

Health conditions that affect breathing, such as COPD and asthma, can cause it. Other factors include using a ventilator, diving, and having a neurological condition that affects breathing. Exposure to tobacco smoke increases the risk of conditions that lead to hypercapnia.

Is hypercarbia the same as hypercapnia?

Yes, people use these terms interchangeably. They both refer to a condition in which there is too much carbon dioxide in the blood. If this situation persists for a long time, or there is significant cardiopulmonary disease, there will not be enough oxygen in the blood. This is called hypoxemia.

Summary

Hypercapnia is when there is too much carbon dioxide in the blood. Addressing the underlying cause is key to managing symptoms and improving a person’s quality of life.

Anyone who has symptoms that may indicate hypercapnia should consult a doctor. The symptoms may be a sign of an underlying condition that needs treatment.

COPD
Respiratory
Blood / Hematology

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Chapman K, et al. (2023). Hypercarbia.https://www.ncbi.nlm.nih.gov/books/NBK559154/
Dorst J, et al. (2019). Non-invasive ventilation and hypercapnia-associated symptoms in amyotrophic lateral sclerosis [Abstract].https://pubmed.ncbi.nlm.nih.gov/30394534/
Gioia MR, et al. (2019). Neurological evaluation in patients undergoing non-invasive mechanical ventilation for acute hypercapnic encephalopathy: Comparison of two different scores.https://erj.ersjournals.com/content/54/suppl_63/PA2319
Hashmi MF, et al. (2024). Asthma.https://www.ncbi.nlm.nih.gov/books/NBK430901/
Nin N, et al. (2017). Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630225/
Rawat D, et al. (2023). Hypercapnea.https://www.ncbi.nlm.nih.gov/books/NBK500012/
Rhee MSM, et al. (2021). Carbon dioxide increases with face masks but remains below short-term NIOSH limits.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049746/
Shah NM, et al. (2021). Defining obesity hypoventilation syndrome.https://pmc.ncbi.nlm.nih.gov/articles/PMC8753617/
Sivakumar K, et al. (2018). Central hypoventilation: A rare complication of Wallenberg syndrome.https://www.hindawi.com/journals/crinm/2018/4894820/
Slowik JM, et al. (2022). Obstructive sleep apnea.https://www.ncbi.nlm.nih.gov/books/NBK459252/
Strapazzon G, et al. (2021). Effects of hypothermia, hypoxia, and hypercapnia on brain oxygenation and hemodynamic parameters during simulated avalanche burial: A porcine study.https://journals.physiology.org/doi/full/10.1152/japplphysiol.00498.2020
Tsonas AM, et al. (2022). Clinical characteristics, physiological features, and outcomes associated with hypercapnia in patients with acute hypoxemic respiratory failure due to COVID–19---insights from the PRoVENT–COVID study.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947815/
Use and care of masks. (2022).https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html
What is COPD? (2024).https://www.nhlbi.nih.gov/health/copd

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Medically reviewed by Megan Soliman, MD — Written by Jayne Leonard — Updated on December 23, 2024

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Human Biology

What is hypercapnia?

What are the symptoms of hypercapnia?

Mild symptoms

Severe symptoms

What are the causes and risk factors of hypercapnia?

COPD

Asthma

Sleep apnea

Nerve disorders and muscular problems

Other causes

Does wearing a face mask cause hypercapnia?

How do doctors diagnose hypercapnia?

What are the treatment options for hypercapnia?

Ventilation

Medication

Oxygen therapy

Lifestyle changes

Surgery

Can a person prevent or lower their risk of hypercapnia?

Frequently asked questions

What is hypercapnia?

Can hypercapnia be reversed?

Can hypercapnia cause a stroke?

How long can a person live with hypercapnia?

What causes hypercapnia?

Is hypercarbia the same as hypercapnia?

Summary

How we reviewed this article:

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