摘要
Carbon dioxide is a waste product of aerobic cellular respiration in all aerobic life forms. PaCO2 represents the balance between the carbon dioxide produced and that eliminated. Hypocapnia remains a common - and generally underappreciated - component of many disease states, including early asthma, high-altitude pulmonary edema, and acute lung injury. Induction of hypocapnia remains a common, if controversial, practice in both adults and children with acute brain injury. In contrast, hypercapnia has traditionally been avoided in order to keep parameters normal. More recently, advances in our understanding of the role of excessive tidal volume has prompted clinicians to use ventilation strategies that result in hypercapnia. Consequently, hypercapnia has become increasingly prevalent in the critically ill patient. Hypercapnia may play a beneficial role in the pathogenesis of inflammation and tissue injury, but may hinder the host response to sepsis and reduce repair. In contrast, hypocapnia may be a pathogenic entity in the setting of critical illness. The present paper reviews the current clinical status of low and high PaCO2 in the critically ill patient, discusses the insights gained to date from studies of carbon dioxide, identifies key concerns regarding hypocapnia and hypercapnia, and considers the potential clinical implications for the management of patients with acute lung injury.
摘要译文
二氧化碳是有氧细胞呼吸的废产物中的所有需氧生活formsPaCO 2表示所产生的二氧化碳，并且消除之间的平衡碳酸血症仍然是一个共同 - 及通常低估 - 许多疾病状态，包括早期哮喘，高空肺水肿，急性肺损伤的分量低碳酸血症的诱导仍然是一个常见的，如果有争议，实践成人和儿童急性脑injuryIn相反，高碳酸血症历来被避免，以保持参数最近normalMore，在我们的过度的潮气量的作用的认识的进步促使临床医生使用导致hypercapniaConsequently通气策略，高碳酸血症已经成为越来越普遍的危重patientHypercapnia炎症和组织损伤的发病机理可起到有益的作用，但可能阻碍宿主反应败血症和减少repairIn相反，低碳酸血症可能是重大疾病的设置一个致病实体本文综述了低和高二氧化碳分压的目前的临床状态的危重病人，讨论见解迄今取得的二氧化碳的研究，关于确定低碳酸血症和高碳酸血症关键问题，并考虑了患者的管理急性肺损伤的潜在临床意义
Gerard Curley [1] [2] John G Laffey [1] [2] Brian P Kavanagh [3]. Bench-to-bedside review: Carbon dioxide[J]. Critical Care, 2010,14(2)