Carbon dioxide clearance in critical care

Lung protective ventilation limiting tidal volumes and airway pressures were proven to reduce mortality in patients with acute severe respiratory failure. Hypercapnia and hypercapnic acidosis is often noted with lung protective ventilation. While the protective effects of lung protective ventilation...

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Bibliographic Details
Published in:Anaesthesia and intensive care 2013-03, Vol.41 (2), p.157-162
Main Authors: Tiruvoipati, R, Botha, J A, Pilcher, D, Bailey, M
Format: Article
Language:English
Subjects:
Acidosis - therapy
Acute Lung Injury - metabolism
Animals
Carbon dioxide
Carbon Dioxide - metabolism
Care and treatment
Critical Care
Critical care medicine
Extracorporeal Circulation
Health aspects
Humans
Hypercapnia - physiopathology
Hypercapnia - therapy
Mortality
Practice
Prevention
Prognosis
Respiratory Distress Syndrome, Adult - metabolism
Respiratory insufficiency
United Kingdom
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Summary:Lung protective ventilation limiting tidal volumes and airway pressures were proven to reduce mortality in patients with acute severe respiratory failure. Hypercapnia and hypercapnic acidosis is often noted with lung protective ventilation. While the protective effects of lung protective ventilation are well recognised, the role of hypercapnia and hypercapnic acidosis remains debatable. Some clinicians argue that hypercapnia and hypercapnic acidosis protect the lungs and may be associated with improved outcomes. To the contrary, some clinicians do not tolerate hypercapnic acidosis and use various techniques including extracorporeal carbon dioxide elimination to treat hypercapnia and acidosis. This review aims at defining the effects of hypercapnia and hypercapnic acidosis with a focus on the pros and cons of clearing carbon dioxide and the modalities that may enhance carbon dioxide clearance.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X1304100129