過度換氣處置專區
認識換氣過度症候群
定義
由於急性焦慮所引起之生理或心理反應時，個案會不自主地加快呼吸速率，導致每分鐘通氣量超過其個體代謝的需求、排出過量之二氧化碳、產生低二氧化碳血症(hypocapnia)以及呼吸性鹼中毒(respiratory alkalosis)；個案且因有吸不到空氣之缺氧感，情緒會更加焦慮，反覆呈現非自主性之淺而快的呼吸型態。
發作的原因
1.源於壓力、食物或藥物之誘發，例如：情緒壓力、工作壓力、咖啡、茶以及酒精等，都已被證實可能引起換氣過度症候群。
2.負向情緒(如：氣憤、恐懼、緊張…等)之誘發，可能是長期累積負向情緒導致自主(自律)神經系統失調，讓個案出現非自主性之淺而快的呼吸型態、缺氧感。
症狀
個案在經歷淺而快的呼吸型態約1分鐘左右，緊接著會出現下列症狀：
1.心臟：胸悶、胸痛、心悸、喘不過氣。
2.神經系統：頭暈、頭痛、手腳或臉部發麻。
3.腸胃系統：肚子發脹、消化不良、排氣或口乾舌燥。
4.疲勞虛弱、頭重腳輕、運動耐力不足。
由於個案經常是全身性的反應合併上述症狀，因此醫師會建議接受相關功能之醫學檢查。
哪些人容易發生「換氣過度症候群」？
1.性別：男：女＝1：7。
2.年齡：13~30歲的女性或15~55歲者。
3.過去病史:二尖瓣脫垂。
4.人格特質：Ａ型人格（行動快速、要求完美者）
5.生活型態：人際關係、工作或生活方面突然有異動者。
治療
1.目前無特效藥物，找出誘發病源，才是根本之道。
2.若需要藥物幫忙：可依醫囑使用抗焦慮藥物及鎮靜劑。
3.接受心理治療及肌肉放鬆之訓練，冥想或催眠治療亦有助益。
4.採用腹式呼吸，在醫療臨床上是有成效的。
5.除非能確認個案無任何呼吸系統的疾病，否則不建議給予紙袋呼吸。
預防之道
1.適當發洩負向情緒，勿刻意壓抑。
2.認識過度換氣症候群的初發症狀，及早提醒自己放鬆情緒及放慢呼吸。
3.若過度換氣症候群一再發生，應尋求適當諮商管道(如身心科醫師)，以辦識並處理負向情緒之來源。
4.協助者勿與個案一起緊張，此舉會令個案病情加重，只須陪伴並安撫個案的情緒，提醒個案放慢呼吸、採腹式深呼吸法；若能有效作到，於5-10分鐘內，即可將症狀緩和下來。
5.平時應避免熬夜、勿濫用搖頭丸、安非他命等毒品，或咖啡、茶等含咖啡因之刺激性飲料。
Get To Know Hyperventilation Syndrome
Definition
Physiological or psychological reaction to acute anxiety may include a quickening of the involuntary respiration rate, resulting per minute ventilation exceeding the needs of an individual’s metabolism. This excessive discharge of carbon dioxide produces hypocapnia and respiratory alkalosis. In some cases, because there is a sense of hypoxic air suction, the individual will experience higher anxiety, repeated involuntary shallow and fast breathing patterns.
Flare-up Reason
1. Originating from stress, food or drugs, various stimulants including emotional stress, work stress, coffee, tea, alcohol have been confirmed to cause hyperventilation syndrome.
2. Negative emotions (such as: anger, fear, stress, etc.) may be induced by the long-term accumulation of negative emotions which leads to dysfunction of the autonomous nervous system, and induces cases of non-autonomous rapid shallow breathing patterns and sense of hypoxia.
Symptoms
Suffers will experience rapid shallow breathing patterns for about one minute, followed by the symptoms below:
1. Heart: chest distress, chest pain, heart palpitations, shortness of breath
2. Nervous system: dizziness, headache, numbness in hands, feet or face
3. Gastrointestinal system: bloating, indigestion, flatulence or dry mouth
4. Fatigue, weakness, lightheadedness, lack of exercise endurance
Since the sufferer will usually have overall systemic symptoms’ response, doctors generally recommend related medical examinations.
Those prone to Hyperventilation Syndrome include:
1. Gender: Male: Female = 1:7
2. Age: 13 to 30 year-old females or 15 to 55 year-old individuals
3. Past History: Mitral Valve Prolapse
4. Personality: Type A personality (rapid movers, perfectionists)
5. Lifestyle: People who are facing change in interpersonal relationships, work or life
Treatment
1. There is no specific medicine for this; identifying the root cause(s) is the fundamental path toward relief.
2. If you need to take medicine to relieve symptoms, follow the doctor's orders regarding use of anti-anxiety drugs and sedatives.
3. Psychological treatment, muscle relaxation training, meditation or hypnosis therapy is helpful.
4. Abdominal breathing has proven effective in clinical situations.
5. Unless one is certain that there is no respiratory disease, it is not recommended to breathe into a paper bag.
Prevention
1. Vent negative emotions appropriately and do not intentionally suppress your emotions.
2. Get to know the early symptoms of hyperventilation so as to reminding yourself to relax and breathe slowly.
3. If hyperventilation is recurring, seek appropriate consultation (such as with a psychiatrist) to identify and deal with the origin of negative emotions.
4. Anyone assisting must not be as nervous as the sufferer, as this will lead to a worse flare up. Simply accompany the person with calm emotions to best help the sufferer. Please remind the sufferer to breathe slowly and take deep abdominal breaths; this will help that person to calm down within 5 to 10 minutes and the symptoms can be relieved.
5. Individuals prone to hyperventilation should avoid staying up late, using ecstasy, amphetamines or other drugs, taking coffee, tea or other caffeinated beverages.