Carbon Dioxide Narcosis

Hypercapnia, a state of elevated serum carbon dioxide (CO), can manifest as a broad spectrum of disease, the most severe of which is CO narcosis. The delineating feature of CO narcosis is a depressed level of consciousness. It is essential to recognize impending or current CO narcosis; if left untreated, it can result in coma or death. This topic primarily focuses on CO narcosis, but it is crucial to appreciate that hypercapnia has multiple end-organ effects contributing to the patient's deterioration. Many etiologies contribute to hypercapnia; the most commonly encountered is chronic obstructive pulmonary disease (COPD). Treatment is focused on fixing the underlying cause and demands an interprofessional approach to optimize patient outcomes.