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Updated: Jun 18, 2025

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Published on: April 7, 2021
Pathophysiology of Chronic Hypercapnic Respiratory Failure
Budhima Nanayakkara1, Stephen McNamara2
1Charles Sturt University, 346 Leeds Parade, Orange, NSW 2800, Australia; Department of Medicine, Orange Health Service, Orange, NSW 2800, Australia; University of Sydney, Camperdown, NSW 2006, Australia.
Abstract:
Chronic hypercapnic respiratory failure occurs in several conditions associated with hypoventilation. The mechanisms underlying the development of chronic hypercapnia include a combination of processes that increase metabolic CO2 production, reduce minute ventilation (V'e), or increase dead space fraction (Vd/Vt). Fundamental to the pathophysiology is a mismatch between increased load and a reduction in the capacity of the respiratory pump to compensate. Though neural respiratory drive may be decreased in a subset of central hypoventilation disorders, it is more commonly increased in attempting to maintain the load-capacity homeostatic balance.
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