After 30–90 min, the respiratory center was depressed, and hypotension occurred gradually or suddenly from reduced cardiac output, leading to an apnea and eventually to circulatory arrest. At higher concentrations of CO2, unconsciousness occurred almost instantaneously and respiratory movement ceased in 1 minute. After a few minutes of apnea, circulatory arrest was seen. These findings imply that the cause of death in breathing high concentrations of CO2 is not the hypoxia but the intoxication of carbon dioxide. Treatment
The treatment for acute hypercapnic respiratory failure depends on the underlying cause, but may include medications and mechanical respiratory support. In those without contraindications, non-invasive ventilation (NIV) is often used in preference to invasive mechanical ventilation. In the past, the drug doxapram (a respiratory stimulant), was used for hypercapnia in acute exacerbation of chronic obstructive pulmonary disease but there is little evidence to support its use compared to NIV, and it does not feature in recent professional guidelines.Very severe respiratory failure, in which hypercapnia may also be present, is often treated with extracorporeal membrane oxygenation (ECMO), in which oxygen is added to and carbon dioxide removed directly from the blood.A relatively novel modality is extracorporeal carbon dioxide removal (ECCO2R). This technique removes CO2 from the bloodstream and may reduce the time mechanical ventilation is required for those with AHRF; it requires smaller volumes of blood flow compared to ECMO. Terminology
Hypercapnia is the opposite of hypocapnia, the state of having abnormally reduced levels of carbon dioxide in the blood.
Additionally, in order to check sterility post-vasectomy, a semen analysis is performed after 3 months and 20 ejaculations to establish azoospermia (no sperm count in the ejaculate).Vasectomy can also be reversed, which is a more technically challenging procedure than a vasectomy that is performed by less urologists and is a heavier financial burden as it is usually not covered by insurances. Approximately 3-6% of people opt for a reversal due to the death of a child, change in partner, increase in financial abilities, or to find relief from postvasectomy pain syndrome. With advances in medical operations since the 1970s, there has since been increased interest in vasectomy reversals and greater chances of success for patency and pregnancy rates.Vasectomy reversal has a varying success rate. A recent study showed that the most important indicator of pregnancy after vasectomy reversal was the age of the female partner. The two most favorable predictors of success were having a female partner less than 40 years of age and having the reversal performed less than 15 years after vasectomy. Aside from the variation in success, vasectomy reversal also has major economic implications. The cost of a vasectomy reversal can range from $16,000-$30,000 and it is usually an out-of-pocket expense due to lack of insurance coverage. == References ==