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MAI) Mosul for Anesthesia & ICU)

This website belong to department of anaesthesia & ICU in Mosul city , Iraq

    Hyperventilation Syndrome Workup 4

    المشرف العام

    عدد الرسائل : 213
    العمر : 52
    تاريخ التسجيل : 2008-07-26

    Hyperventilation Syndrome Workup 4 Empty Hyperventilation Syndrome Workup 4

    Post by yagocom Wed Mar 14, 2012 10:06 pm

    Laboratory Studies
    Upon a first attack of acute hyperventilation syndrome, the diagnosis depends on recognizing the typical constellation of signs and symptoms and ruling out the serious etiologies that can cause the presenting symptoms.

    Acute coronary syndrome and pulmonary embolism are the two most common serious entities that may present in a similar way to hyperventilation syndrome. Usually, clinical assessment is sufficient to rule these out. Depending on that assessment, more specific testing is sometimes warranted.

    A standard workup for atypical chest pain, including pulse oximetry, chest radiography, and ECG, may still be warranted depending on the clinical picture.

    Patients with a history of hyperventilation syndrome who have undergone an appropriate workup at some earlier time may not need any further laboratory evaluation in the setting of a recurrence. Recognition of the typical constellation of dyspnea, agitation, dizziness, atypical chest pain, tachypnea and hyperpnea, paresthesias, and carpopedal spasm in a young, otherwise healthy patient with an adequate prior evaluation is sufficient to make the diagnosis.

    A low pulse oximetry reading in a patient who is hyperventilating should never be attributed to hyperventilation syndrome. The clinician should evaluate the patient for other causes of hyperventilation.

    A normal pulse oximetry reading is not helpful because a severe defect in gas exchange can easily be masked by hyperventilation. A fraction of patients with chronic pulmonary embolism will have compensated chronic hyperventilation that may mimic primary chronic hyperventilation.

    Arterial blood gas measurement
    An arterial blood gas (ABG) measurement is indicated if any doubt exists as to the patient's underlying respiratory status; it may be helpful when HVS-induced acidosis is suspected, or when shunting or impaired pulmonary gas exchange is considered.

    ABG sampling confirms a compensated respiratory alkalosis in a majority of cases. The pH is typically near normal, with a low pCO2 and low HCO3.

    ABG is also useful in ruling out toxicity from carbon monoxide poisoning, which may present in a similar fashion to HSV.[5]

    Other tests
    Toxicology screen is indicated.

    If acute pulmonary embolism is being considered, a quantitative enzyme-linked immunosorbent assay (ELISA) D-dimer assay may be helpful.

      Current date/time is Sat Jan 29, 2022 2:08 pm