tailieunhanh - Báo cáo y học: " Bench-to-bedside review: Permissive hypercapnia"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Bench-to-bedside review: Permissive hypercapnia. | Available online http content 9 1 51 Review Bench-to-bedside review Permissive hypercapnia Donall O Croinin1 Martina Ni Chonghaile2 Brendan Higgins3 and John G Laffey4 Clinical Research Fellow Department of Physiology University College Dublin Dublin 2Clinical Research Fellow Department of Anaesthesia University College Hospital and Department of Anaesthesia Clinical Sciences Institute National University of Ireland Galway Ireland 3Postdoctoral Research Fellow Department of Anaesthesia Clinical Sciences Institute National University of Ireland Galway Ireland 4Clinical Lecturer Department of Anaesthesia University College Hospital and Department of Anaesthesia Clinical Sciences Institute National University of Ireland Galway Ireland Corresponding author John G Laffey Published online 5 August 2004 Critical Care 2005 9 51-59 DOI cc2918 This article is online at http content 9 1 51 2004 BioMed Central Ltd Abstract Current protective lung ventilation strategies commonly involve hypercapnia. This approach has resulted in an increase in the clinical acceptability of elevated carbon dioxide tension with hypoventilation and hypercapnia permitted in order to avoid the deleterious effects of high lung stretch. Advances in our understanding of the biology of hypercapnia have prompted consideration of the potential for hypercapnia to play an active role in the pathogenesis of inflammation and tissue injury. In fact hypercapnia may protect against lung and systemic organ injury independently of ventilator strategy. However there are no clinical data evaluating the direct effects of hypercapnia per se in acute lung injury. This article reviews the current clinical status of permissive hypercapnia discusses insights gained to date from basic scientific studies of hypercapnia and acidosis identifies key unresolved concerns regarding hypercapnia and considers the potential clinical implications for the management of patients