Re-examining Permissive Hypercapnia in ARDS A Narrative Review

被引：50

作者：

Barnes, Tavish ^{[1
]}

Zochios, Vasileios ^{[2
]}

Parhar, Ken ^{[1
]}

机构：

[1] Univ Calgary, Dept Crit Care Med, Calgary, AB, Canada

[2] Univ Birmingham, Univ Hosp Birmingham NHS Fdn Trust, Coll Med & Dent Sci, Dept Crit Care Med,Queen Elizabeth Hosp, Birmingham, England

来源：

CHEST | 2018年 / 154卷 / 01期

关键词：

acute cor pulmonale; ARDS; mechanical ventilation; permissive hypercapnia; right ventricular dysfunction; RESPIRATORY-DISTRESS-SYNDROME; INDUCED LUNG INJURY; ACUTE COR-PULMONALE; TIDAL VOLUME REDUCTION; PROTECTIVE VENTILATION; PROGNOSTIC VALUE; ACUTE HYPOXEMIA; PRONE POSITION; CARBON-DIOXIDE; RENAL-FUNCTION;

D O I：

10.1016/j.chest.2017.11.010

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Lung-protective ventilation (LPV) has become the cornerstone of management in patients with ARDS. A subset of patients is unable to tolerate LPV without significant CO2 elevation. In these patients, permissive hypercapnia is used. Although thought to be benign, it is becoming increasingly evident that elevated CO2 levels have significant physiological effects. In this narrative review, we highlight clinically relevant end-organ effects in both animal models and clinical studies. We also explore the association between elevated CO2, acute cor pulmonale, and ICU mortality. We conclude with a brief review of alternative therapies for CO2 management currently under investigation in patients with moderate to severe ARDS.

引用

页码：185 / 195

页数：11

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