How to Improve Co2 Levels

Carbon dioxide (CO2) levels in the blood are regulated through respiration, even when asleep or unconscious, unless there is a brain injury. Exhaled CO2 levels can change with each breath, depending on metabolic rate and level of activity. Sedated patients relying on ventalatory support require monitoring of CO2 levels to maintain proper pH balance; this is accomplished through capnography (the actual measurement of exhaled CO2) and arterial blood gasses (ABG, which measures blood CO2 and pH), because a forced change in CO2 levels will often alter the blood pH levels, which are critical to every system in the body.

Things You'll Need

• Ventilator with patient tubing
• 50cc lengths of corrugated ventilator tubing
• ABG kit or arterial line
• Capnograph
• Paper or plastic bag with 1-quart capacity
• 15mm Multi-Adaptor

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Instructions

Intubated patient on ventilator

• 1

  Increase respiratory rate to lower blood CO2 level (hyperventilation); monitor pH through arterial blood gasses (ABG) to ensure safe acid-base balance.

• 2

  Decrease respiratory rate to raise blood CO2 level (hypoventilation); perform ABG to assure safe pH levels. Note: if the patient is conscious or mildly sedated, they may trigger the ventilator to deliver more breaths per minute than desired; this, however, usually indicates an appropriate respiratory drive to self-maintain pH levels in the blood.

• 3

  Add dead space to ventilator tubing by connecting 50cc lengths of corrugated tubing where the ventilator circuit connects to the endotracheal tube to increase CO2 levels in conscious ventilator patients. The exhaled air (high in CO2) will remain trapped in the dead space at the end of exhalation and taken back in with the next breath.

• 4

  Never add dead space to ventilator tubing without written orders by the attending physician.

• 5

  Use a capnograph to measure end-tidal CO2 levels and monitor blood pH via ABG. Ideally, the patient should have an arterial line to facilitate ABG draws.

Conscious non-intubated patient

• 6

  Breathe rapidly and deeply to lower CO2 levels in the blood (hyperventilation). Note: this is not recommended, as it serves no medical value.

• 7

  Using the 1-quart capacity bag, hold it over mouth and nose and rebreathe exhaled air to raise CO2 levels in the blood. This is useful for those hyperventilating to prevent unconsciousness.

• 8

  Stop rebreathing from the bag if dizzy or giddy; do not rebreathe exhaled air for more than one minute as it can lower blood CO2 (and raise blood pH) dangerously.