1995
DOI: 10.1111/j.1399-6576.1995.tb04360.x
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How far can we go with permissive hypercapnia? A case presentation and some biased comments with emphasis on maintaining normal haemoglobin level

Abstract: The respiratory management strategy of small tidal volume with permissive hypercapnia has been adopted to avoid further aggravation of lung injury due to high airway pressure with some impressive success (1). No consensus, however, has been established in terms of the rate of increase in PaCO? and its upper limit. Recently, our colleague in the intensive care unit experienced a severe case of ARDS successfully treated with the above strategy despite of the fact that during the course of treatment, the highest … Show more

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Cited by 7 publications
(5 citation statements)
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“…Although severe hypercapnia associated with a PaCO 2 of Ն150 mm Hg is sometimes encountered clinically, such reports are uncommon (22)(23)(24). Previous studies reported that severe hypercapnia occurs in patients with respiratory disorders, such as severe asthma (22) and acute respiratory distress syndrome (23). In our study, a high PaCO 2 of up to 250 mm Hg was maintained and then returned to normocapnia.…”
Section: Discussionmentioning
confidence: 98%
“…Although severe hypercapnia associated with a PaCO 2 of Ն150 mm Hg is sometimes encountered clinically, such reports are uncommon (22)(23)(24). Previous studies reported that severe hypercapnia occurs in patients with respiratory disorders, such as severe asthma (22) and acute respiratory distress syndrome (23). In our study, a high PaCO 2 of up to 250 mm Hg was maintained and then returned to normocapnia.…”
Section: Discussionmentioning
confidence: 98%
“…Patients with excessively low respiratory system compliance may result in markedly low tidal volume and at times even below the recommended 6 to 8 mL/kg of ideal body weight (IBW). This may culminate in hypercapnia and severe respiratory acidosis [ 2 , 3 ].…”
Section: Introductionmentioning
confidence: 99%
“…[ 2 ] No consensus, however, has been established in terms of its upper limits and the optimal CO 2 level for mechanically ventilated patients with acute lung injury (ALI). [ 3 4 ] The concept of an optimal CO 2 concentration is essential as most physiological systems are saturable and it is therefore reasonable that an effective upper limit of CO2, a point beyond which advantages shift toward harmful effects, exists. [ 3 ]…”
Section: Introductionmentioning
confidence: 99%