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Hypercapnia in the critically ill 

Hypercapnia in the critically ill
Chapter:
Hypercapnia in the critically ill
Author(s):

John G. Laffey

and Brian P. Kavanagh

DOI:
10.1093/med/9780199600830.003.0086
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date: 19 February 2020

Hypercapnia is a central component of current ‘protective’ ventilator management. Hypercapnia, and the associated acidosis, has potentially important biologic effects on immune responses, injury and repair. Arterial carbon dioxide tension PaCO2 is tightly governed under physiological conditions and small elevations rapidly increase spontaneous minute ventilation. In the mechanically-ventilated patient, elevated PaCO2 usually reflects reduced elimination. This can be because tidal volume or respiratory rate delivered by the ventilator are reduced, or because of the diseased lung per se. Hypercapnia has many effects that are clinically obvious, but research over the last decade reveals important consequences on inflammatory and cellular mechanisms that are not apparent at the bedside.

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