Treatment of hypercapnia requires maneuvers to increase minute ventilation, both the rate and the tidal volume. This involves ensuring a patent airway and may require mechanical ventilation. The disposition of hypercapnic patients depends primarily on the underlying cause and severity. In general, patients with hypercapnia that causes CNS symptoms should be hospitalized. Also, patients with neuromuscular disease—either congenital or acquired—who present with acute hypercapnia should be hospitalized. Some COPD patients have chronic hypercapnia and do not require admission provided they are stable. Conversely, patients with COPD who display worsening hypercapnia despite maximal therapy require hospital admission.
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