Table of ContentsView AllTable of ContentsWhat Is Hypercapnia?SymptomsCausesDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
What Is Hypercapnia?
Symptoms
Causes
Diagnosis
Treatment
Prevention
Hypercapniadescribes high carbon dioxide (CO2) levels in the blood above 45 mm Hg. It can happen when there is an overproduction of CO2 or an inability to efficiently clear it from the body. Hypercapnia can be a life-threatening health crisis.
Carbon dioxide is produced naturally in the body during certain cellular processes. It is usually removed during exhalation, but certain medical conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, and neuromuscular diseases can cause it to build up in the blood.
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As you inhale, air enters your lungs, and oxygen then moves into the blood, which carries it to your body systems. Once you have inhaled oxygen, you exhale carbon dioxide. This process is called gas exchange.
Medical issues arise when not enough oxygen enters the lungs. However, problems can also occur if too little carbon dioxide is exhaled, which causes the body’s CO2 levels to spike.
This state is known as hypercapnia—sometimes calledhypercarbiaor carbon dioxide retention.
Hypercarbia vs. Hypercapnia and HypoxemiaThe terms “hypercarbia” and “hypercapnia” both describe conditions in which carbon dioxide levels in the body are elevated. They are often used interchangeably.Hypercapnia and hypoxemia mean two different things becausehypoxemiarefers to low levels of oxygen in the blood. It can lead to hypoxia, which describes low oxygen levels in your body tissues and organs.
Hypercarbia vs. Hypercapnia and Hypoxemia
The terms “hypercarbia” and “hypercapnia” both describe conditions in which carbon dioxide levels in the body are elevated. They are often used interchangeably.Hypercapnia and hypoxemia mean two different things becausehypoxemiarefers to low levels of oxygen in the blood. It can lead to hypoxia, which describes low oxygen levels in your body tissues and organs.
The terms “hypercarbia” and “hypercapnia” both describe conditions in which carbon dioxide levels in the body are elevated. They are often used interchangeably.
Hypercapnia and hypoxemia mean two different things becausehypoxemiarefers to low levels of oxygen in the blood. It can lead to hypoxia, which describes low oxygen levels in your body tissues and organs.
Hypercapnia Symptoms
Many people are unaware that they have mild hypercapnia. When you consider the common, everyday nature of the symptoms, you might understand why.
The symptoms of high CO2 levels can include:
When CO2 levels become elevated, special receptors in your brain detect the increased blood level. These receptors send messages to your lungs to make you breathe more deeply and/or faster until your CO2 reaches a normal level.
With severe hypercapnia, though, the symptoms and complications can become life-threatening.
What happens to the body during hypercapnia?Hypercapnia affects your blood’s pH balance. When you have hypercapnia, your blood becomes too acidic.If hypercapnia happens slowly, your kidneys may be able to help restore the normal pH balance.Some people experience only mild symptoms including headache and fatigue. When the mechanisms designed to protect this balance in your body no longer work, however, more severe symptoms of difficulty breathing, respiratory failure, seizure, and coma can occur.
What happens to the body during hypercapnia?
Hypercapnia affects your blood’s pH balance. When you have hypercapnia, your blood becomes too acidic.If hypercapnia happens slowly, your kidneys may be able to help restore the normal pH balance.Some people experience only mild symptoms including headache and fatigue. When the mechanisms designed to protect this balance in your body no longer work, however, more severe symptoms of difficulty breathing, respiratory failure, seizure, and coma can occur.
Hypercapnia affects your blood’s pH balance. When you have hypercapnia, your blood becomes too acidic.
If hypercapnia happens slowly, your kidneys may be able to help restore the normal pH balance.
Some people experience only mild symptoms including headache and fatigue. When the mechanisms designed to protect this balance in your body no longer work, however, more severe symptoms of difficulty breathing, respiratory failure, seizure, and coma can occur.
Severe Symptoms
Severe hypercapnia can cause noticeable and distressing effects. Unlike mild hypercapnia, the body is incapable of restoring CO2 balance, which can lead to urgent symptoms:
Severe cases of hypercapnia can lead to respiratory failure and coma if left untreated. Call 911 if you experience any of these symptoms.
Hypercapnia Causes
Hypercapnia results from excess CO2 production or reduced CO2 exhalation from the lungs. Some health issues may be at the root of these dynamics, and a number of risk factors may increase the odds of the condition developing.
It’s rare for someone who is healthy to develop severe (also known as “medically significant”) hypercapnia. But certain types of health issues can trigger the condition.
Metabolic Changes
Illnesses, infections, and severe trauma can cause an alteration in the body’s metabolism, resulting in excess CO2 production. If your breathing can’t catch up with your need to exhale CO2 from your body, you can develop an elevated blood CO2 level.
Causes of excess CO2 production include:
Onset of Lung Disease
Lung disease can interfere with CO2 removal. A situation calledventilation/perfusion (V/Q) mismatchoccurs when you have severe lung damage that prevents the flow of blood and/or air in your lungs.
The following chronic conditions can cause CO2 gas to build up in the body:
COPD is a major cause of hypercapnia. But even people with severe or end-stage COPD may not develop hypercapnia.
Muscle Weakness
Neuromuscular diseases such as amyotrophic lateral sclerosis (ALS) andmuscular dystrophycan make it a struggle to breathe, resulting in a buildup of blood CO2 levels.
Myasthenia gravisis another neuromuscular cause of hypercapnia.
Brain Disorders
Genetic Factors
In rare cases, high CO2 blood levels can be due to a genetic condition known as alpha-1 antitrypsin (AAT) deficiency.
AAT deficiency occurs when a person inherits two mutated AAT genes—one from each parent. While it can occur in any ethnicity, it is more common among people of Northern European descent.
Other Risk Factors
Anything that can damage your lungs can put you at risk for hypercapnia. This includes:
Can Wearing a Face Mask Trigger Hypercapnia?No, multiple studies have found no link between face mask use and an increased incidence of hypercapnia. In one study, continuous use of high-quality face masks caused a slight but temporary increase in CO2 levels in healthy adults. However, this rise did not exceed National Institute for Occupational Safety and Health (NIOSH) limits.Additional research studied mask use in people with COPD and found no increased risk for hypercapnia.
Can Wearing a Face Mask Trigger Hypercapnia?
No, multiple studies have found no link between face mask use and an increased incidence of hypercapnia. In one study, continuous use of high-quality face masks caused a slight but temporary increase in CO2 levels in healthy adults. However, this rise did not exceed National Institute for Occupational Safety and Health (NIOSH) limits.Additional research studied mask use in people with COPD and found no increased risk for hypercapnia.
How Is Hypercapnia Diagnosed?
Often, the symptoms of mild hypercapnia are simple enough for an experienced healthcare provider to address. They are worth monitoring, particularly if they linger or get worse.
Severe hypercapnia requires a more assertive approach. Efforts usually focus on a search for the underlying cause, and the search begins with a careful history and physical examination.
You will likely need a blood test that measures your CO2 level. Anarterial blood gas(ABG) test measures your blood oxygen, CO2, bicarbonate, and pH.
Typically, blood tests use blood samples taken from a vein. An ABG test requires a sample of blood from your artery.
You may also need other diagnostic tests. In the meantime, you may require intervention with medication and/or assistance with breathing from a breathing mask or mechanical ventilator.
Hypercapnia DiagnosisHypercapnia is usually diagnosed when CO2 pressure measures at 45 mm Hg (millimeters of mercury) or above.
Hypercapnia Diagnosis
Hypercapnia is usually diagnosed when CO2 pressure measures at 45 mm Hg (millimeters of mercury) or above.
Diagnostic Tests
Aside from blood tests, certain go-to tests include:
Hypercapnia Treatment
Treating hypercapnia focuses on improving ventilation so that you can get rid of excess CO2. The type of treatment used depends on the severity of the condition:
PrognosisPeople who have hypercapnia due to a chronic condition tend to have a poorer prognosis than those who do not, even with the same underlying cause.Early diagnosis and effective treatment may contribute to better outcomes.
Prognosis
People who have hypercapnia due to a chronic condition tend to have a poorer prognosis than those who do not, even with the same underlying cause.Early diagnosis and effective treatment may contribute to better outcomes.
How Is Hypercapnia Prevented?
If you have a condition that puts you at risk for high CO2 levels, be sure to follow your treatment plan. Take your medications as prescribed, keep your follow-up appointments, and follow your healthcare provider’s recommendations for monitoring.
Lifestyle changes can also help to prevent CO2 levels from getting too high. This includes:
Summary
Mild hypercapnia can be hard to spot. Having too much carbon dioxide in the body can cause nonspecific symptoms like headache, fatigue, and muscle twitches. Often, it clears up quickly on its own.
With severe hypercapnia, though, the body can’t restore CO2 balance, and the symptoms are more serious. An underlying health condition usually triggers hypercapnia, and the sooner it’s identified, the sooner you can get treatment.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Heart, Lung and Blood Institute.How the lungs work.Davis JS, Allais L, Abdallah C.Caffeine use in the anesthetic management of a patient with congenital central hypoventilation.Cureus. 2022;14(7):e26646. doi:10.7759/cureus.26646Chapter 8 oxygenation. In: Ernstmeyer K, Christman E, eds.Open Resources for Nursing (Open RN). Eau Claire (WI): Chippewa Valley Technical College; 2021.Guyenet PG, Bayliss DA.Central respiratory chemoreception.Handb Clin Neurol.2022;188:37-72. doi:10.1016/B978-0-323-91534-2.00007-2Lemyze M, De Palleja G, Guiot A.Outcome of frail do-not-intubate subjects with end-stage chronic respiratory failure and their opinion of noninvasive ventilation to reverse hypercapnic coma.Respir Care. 2019;64(9):1023-1030. doi:10.4187/respcare.06346Morales-Quinteros L, Camprubí-Rimblas M, Bringué J, Bos LD, Schultz MJ, Artigas A.The role of hypercapnia in acute respiratory failure.Intensive Care Med Exp. 2019;7(Suppl 1):39. doi:10.1186/s40635-019-0239-0Adler D, Pépin JL, Dupuis-Lozeron E, et al.Comorbidities and subgroups of patients surviving severe acute hypercapnic respiratory failure in the intensive care unit.Am J Respir Crit Care Med.2017;196(2):200-207. doi:10.1164/rccm.201608-1666OCHogea SP, Tudorache E, Fildan AP, Fira-Mladinescu O, Marc M, Oancea C.Risk factors of chronic obstructive pulmonary disease exacerbations.Clin Respir J. 2020;14(3):183-197. doi:10.1111/crj.13129Vogt S, Schreiber S, Kollewe K et al.Dyspnea in amyotrophic lateral sclerosis: the Dyspnea-ALS-Scale (DALS-15) essentially contributes to the diagnosis of respiratory impairment.Respir Med. 2019;154:116-121. doi:10.1016/j.rmed.2019.06.014National Heart, Lung, and Blood Institute.Alpha-1 antitrypsin deficiency.U.S. Department of Health and Human Services. Office on Women’s Health.Lung disease.Rhee MSM, Lindquist CD, Silvestrini MT, Chan AC, Ong JJY, Sharma VK.Carbon dioxide increases with face masks but remains below short-term NIOSH limits.BMC Infect Dis. 2021;21(1):354. doi:10.1186/s12879-021-06056-0Patil S.Face mask and hypercapnia in patients with COPD in COVID-19 pandemic…is it real?Chest. 2021;160(4):A1404. doi:10.1016/j.chest.2021.07.1284Burns GP.Arterial blood gases made easy.Clin Med (Lond). 2014;14(1):66-8. doi:10.7861/clinmedicine.14-1-66Xia J, Gu S, Lei W, Zhang J, Wei H, Liu C,et al.High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial.Crit Care. 2022;26(1):109. doi:10.1186/s13054-022-03973-7.American Lung Association.Lung procedures, tests & treatments.Marshall O, Chawla S, Lu H, Pape L, Ge Y.Cerebral blood flow modulation insufficiency in brain networks in multiple sclerosis: A hypercapnia MRI study.J Cereb Blood Flow Metab. 2016;36(12):2087-2095. doi:10.1177/0271678X16654922Morales-Quinteros L, Camprubí-Rimblas M, Bringué J, Bos LD, Schultz MJ, Artigas A.The role of hypercapnia in acute respiratory failure.Intensive Care Med Exp. 2019;7(Suppl 1):39. doi:10.1186/s40635-019-0239-0Yang H, Xiang P, Zhang E, Guo W, Shi Y, Zhang S,et al.Is hypercapnia associated with poor prognosis in chronic obstructive pulmonary disease? A long-term follow-up cohort study.BMJ Open. 2015;5(12):e008909. doi:10.1136/bmjopen-2015-008909
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Heart, Lung and Blood Institute.How the lungs work.Davis JS, Allais L, Abdallah C.Caffeine use in the anesthetic management of a patient with congenital central hypoventilation.Cureus. 2022;14(7):e26646. doi:10.7759/cureus.26646Chapter 8 oxygenation. In: Ernstmeyer K, Christman E, eds.Open Resources for Nursing (Open RN). Eau Claire (WI): Chippewa Valley Technical College; 2021.Guyenet PG, Bayliss DA.Central respiratory chemoreception.Handb Clin Neurol.2022;188:37-72. doi:10.1016/B978-0-323-91534-2.00007-2Lemyze M, De Palleja G, Guiot A.Outcome of frail do-not-intubate subjects with end-stage chronic respiratory failure and their opinion of noninvasive ventilation to reverse hypercapnic coma.Respir Care. 2019;64(9):1023-1030. doi:10.4187/respcare.06346Morales-Quinteros L, Camprubí-Rimblas M, Bringué J, Bos LD, Schultz MJ, Artigas A.The role of hypercapnia in acute respiratory failure.Intensive Care Med Exp. 2019;7(Suppl 1):39. doi:10.1186/s40635-019-0239-0Adler D, Pépin JL, Dupuis-Lozeron E, et al.Comorbidities and subgroups of patients surviving severe acute hypercapnic respiratory failure in the intensive care unit.Am J Respir Crit Care Med.2017;196(2):200-207. doi:10.1164/rccm.201608-1666OCHogea SP, Tudorache E, Fildan AP, Fira-Mladinescu O, Marc M, Oancea C.Risk factors of chronic obstructive pulmonary disease exacerbations.Clin Respir J. 2020;14(3):183-197. doi:10.1111/crj.13129Vogt S, Schreiber S, Kollewe K et al.Dyspnea in amyotrophic lateral sclerosis: the Dyspnea-ALS-Scale (DALS-15) essentially contributes to the diagnosis of respiratory impairment.Respir Med. 2019;154:116-121. doi:10.1016/j.rmed.2019.06.014National Heart, Lung, and Blood Institute.Alpha-1 antitrypsin deficiency.U.S. Department of Health and Human Services. Office on Women’s Health.Lung disease.Rhee MSM, Lindquist CD, Silvestrini MT, Chan AC, Ong JJY, Sharma VK.Carbon dioxide increases with face masks but remains below short-term NIOSH limits.BMC Infect Dis. 2021;21(1):354. doi:10.1186/s12879-021-06056-0Patil S.Face mask and hypercapnia in patients with COPD in COVID-19 pandemic…is it real?Chest. 2021;160(4):A1404. doi:10.1016/j.chest.2021.07.1284Burns GP.Arterial blood gases made easy.Clin Med (Lond). 2014;14(1):66-8. doi:10.7861/clinmedicine.14-1-66Xia J, Gu S, Lei W, Zhang J, Wei H, Liu C,et al.High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial.Crit Care. 2022;26(1):109. doi:10.1186/s13054-022-03973-7.American Lung Association.Lung procedures, tests & treatments.Marshall O, Chawla S, Lu H, Pape L, Ge Y.Cerebral blood flow modulation insufficiency in brain networks in multiple sclerosis: A hypercapnia MRI study.J Cereb Blood Flow Metab. 2016;36(12):2087-2095. doi:10.1177/0271678X16654922Morales-Quinteros L, Camprubí-Rimblas M, Bringué J, Bos LD, Schultz MJ, Artigas A.The role of hypercapnia in acute respiratory failure.Intensive Care Med Exp. 2019;7(Suppl 1):39. doi:10.1186/s40635-019-0239-0Yang H, Xiang P, Zhang E, Guo W, Shi Y, Zhang S,et al.Is hypercapnia associated with poor prognosis in chronic obstructive pulmonary disease? A long-term follow-up cohort study.BMJ Open. 2015;5(12):e008909. doi:10.1136/bmjopen-2015-008909
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Heart, Lung and Blood Institute.How the lungs work.Davis JS, Allais L, Abdallah C.Caffeine use in the anesthetic management of a patient with congenital central hypoventilation.Cureus. 2022;14(7):e26646. doi:10.7759/cureus.26646Chapter 8 oxygenation. In: Ernstmeyer K, Christman E, eds.Open Resources for Nursing (Open RN). Eau Claire (WI): Chippewa Valley Technical College; 2021.Guyenet PG, Bayliss DA.Central respiratory chemoreception.Handb Clin Neurol.2022;188:37-72. doi:10.1016/B978-0-323-91534-2.00007-2Lemyze M, De Palleja G, Guiot A.Outcome of frail do-not-intubate subjects with end-stage chronic respiratory failure and their opinion of noninvasive ventilation to reverse hypercapnic coma.Respir Care. 2019;64(9):1023-1030. doi:10.4187/respcare.06346Morales-Quinteros L, Camprubí-Rimblas M, Bringué J, Bos LD, Schultz MJ, Artigas A.The role of hypercapnia in acute respiratory failure.Intensive Care Med Exp. 2019;7(Suppl 1):39. doi:10.1186/s40635-019-0239-0Adler D, Pépin JL, Dupuis-Lozeron E, et al.Comorbidities and subgroups of patients surviving severe acute hypercapnic respiratory failure in the intensive care unit.Am J Respir Crit Care Med.2017;196(2):200-207. doi:10.1164/rccm.201608-1666OCHogea SP, Tudorache E, Fildan AP, Fira-Mladinescu O, Marc M, Oancea C.Risk factors of chronic obstructive pulmonary disease exacerbations.Clin Respir J. 2020;14(3):183-197. doi:10.1111/crj.13129Vogt S, Schreiber S, Kollewe K et al.Dyspnea in amyotrophic lateral sclerosis: the Dyspnea-ALS-Scale (DALS-15) essentially contributes to the diagnosis of respiratory impairment.Respir Med. 2019;154:116-121. doi:10.1016/j.rmed.2019.06.014National Heart, Lung, and Blood Institute.Alpha-1 antitrypsin deficiency.U.S. Department of Health and Human Services. Office on Women’s Health.Lung disease.Rhee MSM, Lindquist CD, Silvestrini MT, Chan AC, Ong JJY, Sharma VK.Carbon dioxide increases with face masks but remains below short-term NIOSH limits.BMC Infect Dis. 2021;21(1):354. doi:10.1186/s12879-021-06056-0Patil S.Face mask and hypercapnia in patients with COPD in COVID-19 pandemic…is it real?Chest. 2021;160(4):A1404. doi:10.1016/j.chest.2021.07.1284Burns GP.Arterial blood gases made easy.Clin Med (Lond). 2014;14(1):66-8. doi:10.7861/clinmedicine.14-1-66Xia J, Gu S, Lei W, Zhang J, Wei H, Liu C,et al.High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial.Crit Care. 2022;26(1):109. doi:10.1186/s13054-022-03973-7.American Lung Association.Lung procedures, tests & treatments.Marshall O, Chawla S, Lu H, Pape L, Ge Y.Cerebral blood flow modulation insufficiency in brain networks in multiple sclerosis: A hypercapnia MRI study.J Cereb Blood Flow Metab. 2016;36(12):2087-2095. doi:10.1177/0271678X16654922Morales-Quinteros L, Camprubí-Rimblas M, Bringué J, Bos LD, Schultz MJ, Artigas A.The role of hypercapnia in acute respiratory failure.Intensive Care Med Exp. 2019;7(Suppl 1):39. doi:10.1186/s40635-019-0239-0Yang H, Xiang P, Zhang E, Guo W, Shi Y, Zhang S,et al.Is hypercapnia associated with poor prognosis in chronic obstructive pulmonary disease? A long-term follow-up cohort study.BMJ Open. 2015;5(12):e008909. doi:10.1136/bmjopen-2015-008909
National Heart, Lung and Blood Institute.How the lungs work.
Davis JS, Allais L, Abdallah C.Caffeine use in the anesthetic management of a patient with congenital central hypoventilation.Cureus. 2022;14(7):e26646. doi:10.7759/cureus.26646
Chapter 8 oxygenation. In: Ernstmeyer K, Christman E, eds.Open Resources for Nursing (Open RN). Eau Claire (WI): Chippewa Valley Technical College; 2021.
Guyenet PG, Bayliss DA.Central respiratory chemoreception.Handb Clin Neurol.2022;188:37-72. doi:10.1016/B978-0-323-91534-2.00007-2
Lemyze M, De Palleja G, Guiot A.Outcome of frail do-not-intubate subjects with end-stage chronic respiratory failure and their opinion of noninvasive ventilation to reverse hypercapnic coma.Respir Care. 2019;64(9):1023-1030. doi:10.4187/respcare.06346
Morales-Quinteros L, Camprubí-Rimblas M, Bringué J, Bos LD, Schultz MJ, Artigas A.The role of hypercapnia in acute respiratory failure.Intensive Care Med Exp. 2019;7(Suppl 1):39. doi:10.1186/s40635-019-0239-0
Adler D, Pépin JL, Dupuis-Lozeron E, et al.Comorbidities and subgroups of patients surviving severe acute hypercapnic respiratory failure in the intensive care unit.Am J Respir Crit Care Med.2017;196(2):200-207. doi:10.1164/rccm.201608-1666OC
Hogea SP, Tudorache E, Fildan AP, Fira-Mladinescu O, Marc M, Oancea C.Risk factors of chronic obstructive pulmonary disease exacerbations.Clin Respir J. 2020;14(3):183-197. doi:10.1111/crj.13129
Vogt S, Schreiber S, Kollewe K et al.Dyspnea in amyotrophic lateral sclerosis: the Dyspnea-ALS-Scale (DALS-15) essentially contributes to the diagnosis of respiratory impairment.Respir Med. 2019;154:116-121. doi:10.1016/j.rmed.2019.06.014
National Heart, Lung, and Blood Institute.Alpha-1 antitrypsin deficiency.
U.S. Department of Health and Human Services. Office on Women’s Health.Lung disease.
Rhee MSM, Lindquist CD, Silvestrini MT, Chan AC, Ong JJY, Sharma VK.Carbon dioxide increases with face masks but remains below short-term NIOSH limits.BMC Infect Dis. 2021;21(1):354. doi:10.1186/s12879-021-06056-0
Patil S.Face mask and hypercapnia in patients with COPD in COVID-19 pandemic…is it real?Chest. 2021;160(4):A1404. doi:10.1016/j.chest.2021.07.1284
Burns GP.Arterial blood gases made easy.Clin Med (Lond). 2014;14(1):66-8. doi:10.7861/clinmedicine.14-1-66
Xia J, Gu S, Lei W, Zhang J, Wei H, Liu C,et al.High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial.Crit Care. 2022;26(1):109. doi:10.1186/s13054-022-03973-7.
American Lung Association.Lung procedures, tests & treatments.
Marshall O, Chawla S, Lu H, Pape L, Ge Y.Cerebral blood flow modulation insufficiency in brain networks in multiple sclerosis: A hypercapnia MRI study.J Cereb Blood Flow Metab. 2016;36(12):2087-2095. doi:10.1177/0271678X16654922
Morales-Quinteros L, Camprubí-Rimblas M, Bringué J, Bos LD, Schultz MJ, Artigas A.The role of hypercapnia in acute respiratory failure.Intensive Care Med Exp. 2019;7(Suppl 1):39. doi:10.1186/s40635-019-0239-0
Yang H, Xiang P, Zhang E, Guo W, Shi Y, Zhang S,et al.Is hypercapnia associated with poor prognosis in chronic obstructive pulmonary disease? A long-term follow-up cohort study.BMJ Open. 2015;5(12):e008909. doi:10.1136/bmjopen-2015-008909
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