Breathing consists of taking fresh air into the lungs and throwing foul air out from the lungs.
Most people know about oxygen and correctly identify it as the important component of fresh air. Our body needs oxygen to survive and lungs absorb oxygen from the fresh air.
Oxygen is needed to burn fuel to produce energy needed to sustain life. When carbon based fuel burns, it produces a gas called carbon-dioxide or CO2.
Besides absorbing oxygen, the other important function of breathing is to get rid of the CO2 produced in the body. When there is a problem with breathing, it can affect the absorption of oxygen, or excretion of CO2, or sometimes both.
When the problem is with oxygen, it is more readily recognized. Usually, people with low oxygen feel short of breath and appear sick. It is easy to check for adequacy of oxygen in the blood.
A simple device attached to a finger nail can easily detect the percentage of oxygen in the blood. It is, therefore, very rare for inadequacy of oxygen to go undiagnosed.
On the other hand, problems with excretion of CO2 can be somewhat complicated. It mostly happens in people that are getting supplemental oxygen but can also happen in certain special situations. When the lungs can not blow off excess CO2, it accumulates in the blood.
High levels of CO2 make the blood acidic. The acidic blood can produce significant dysfunction of several vital organs. The effects on the brain can be specially pronounced.
When someone is getting supplemental oxygen, it helps correct the problem with low oxygen but does nothing to treat the high CO2. In such cases, patients may not feel shortness of breath but may only have symptoms of high CO2.
They may have weakness, lethargy, confusion and problems with memory and concentration. These symptoms can initially be very subtle and can be missed if you do not pay attention. The acidic blood can continue to cause dysfunction of internal organs and even lead to death without prompt treatment.
The only effective treatment in these cases is forced removal of CO2 from the lungs. In most cases, this can be achieved by using a tight fitting mask connected to a machine. The machine forces air in and out of lungs and help them blow off excess CO2. In some cases, the patient may need to be connected to a mechanical ventilator to blow the CO2 off.
When you have someone on home oxygen treatment, it is important to seek medical attention when you see confusion, loss of memory or lethargy as those could be possible signs of high CO2. A special blood test designed to detect blood gases can help the doctors make the correct diagnosis.
Nabin Sapkota MD is board certified in internal medicine, a hospitalist with Inpatient Physician Associates of Columbus and a physician with the hospitalist program at Columbus Community Hospital. You can read about his new book project "Symptoms and Diagnosis" at symptomsdiagnosisbook.com.