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Blood gas changes during voluntary hyperventilation in normal and disease states.

Normally, involuntary control of respiration maintains the partial pressure of carbon dioxide in arterial blood (PaCO2) within normal limits. The ability to reduce PaCO2 by voluntary hyperventilation for a period of two minutes has been studied in five groups of subjects. Normal volunteers were able to decrease PaCO2 by 47 per cent of their baseline values. Patients with moderately severe chronic obstructive pulmonary disease without carbon dioxide retention decreased PaC02 by 24 per cent. Patients with severe chronic obstructive pulmonary disease, some of whom had resting hypercapnia, decreased PaCO2 by only 12. per cent. Obese subjects with hypoventilation and resting hypercapnia of the same order as the patients with severe chronic obstructive pulmonary disease were able to reduce PaCO2 by 34 per cent, a response that falls within the normal range. Subjects with uremia (metabolic acidosis) and patients with interstitial disease of the lung (respiratory alkalosis) both responded in a normal fashion. The...