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Optimal carbon dioxide levels in critically ill patients Takeshi KAWAGUCHI 1 , Shigeki FUJITANI 1,2 1Department of Emergency and Critical Care Medicine St. Marianna University Hospital 2Tokyo Bay Urayasu Ichikawa Medical Center pp.518-523
Published Date 2018/7/1
DOI https://doi.org/10.11477/mf.3102200532
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Management of hypercapnia is often challenging in patients with pulmonary diseases in the intensive care unit (ICU), but existing literature does not fully explain the effects of hypercapnia and acid-base equilibrium on patient outcomes. Therefore, physiological principles and animal data may need to be evaluated to determine optimal management. In this column, we outline the physiological effects of hypercapnia on the human body, treatment results using permissive hypercapnia, and the effectiveness of extracorporeal carbon dioxide removal (ECCO2R) devices. There is still no consensus on optimal CO2 levels in patients with critical lung illness. While hypercapnia itself may have deleterious effects on the human body, CO2 levels with an acceptable acid-base equilibrium may be acceptable target levels. Permissive hypercapnia using a ventilatory strategy with low tidal volume and low plateau pressure is and will be widely adopted for these patients for the time being. A new treatment strategy may be developed in the future when the results of multicenter studies are available.


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電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル

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