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Posthypercapnic states Correction of persistent hypercapnia in presence of low-salt diet or in a patient with congestive coronary heart failure From Khanna and Kurtzman,32 with permission 192 Plum and Posner�s Diagnosis of Stupor and Coma Table 5�7 Pathophysiology of Respiratory Acidosis Acute Chronic Acute central nervous system melancholy Central sleep apnea Drug overdose (benzodiazepines, Primary alveolar narcotics, barbiturates, hypoventilation propofol, main tranquilizers) Obesity hypoventilation Head trauma syndrome Cerebrovascular accident Spinal cord harm Central nervous system infection Diaphragmatic paralysis (encephalitis) Amyotrophic lateral sclerosis Acute neuromuscular disease Myasthenia gravis Guillain-Barre? syndrome Muscular dystrophy Spinal twine injury Multiple sclerosis Myasthenic crisis Poliomyelitis Botulism Hypothyroidism Organophosphate poisoning Kyphoscoliosis Acute airways disease Thoracic cage disease Status asthmaticus Chronic obstructive Upper airway obstruction (laryngospasm, pulmonary disease angioedema, overseas body aspiration Severe persistent interstitial lung Exacerbation of persistent obstructive illness pulmonary illness Acute parenchymal and vascular illness Cardiogenic pulmonary edema Acute lung harm Multilobular pneumonia Massive pulmonary embolism Acute pleural or chest wall illness Pneumothorax Hemothorax Flail chest From Epstein and Singh,36 with permission. 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