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Permissive hypercapnia或許沒有那麼安全?!

這一期的critical care medicine有一篇探討hypercapnic acidosis對bacterial translocation的文章,動物實驗顯示在有pneumonia的情形下,暴露在hypercapnic acidosis超過兩天會增加bacterial translocation以及加重lung injury。作者的結論是:

Hypercapnic acidosis is a double-edged sword with potentially beneficial or deleterious effects depending on the context in which it occurs. These findings have important implications for the management of protective ventilation strategies in the context of ARDS and the treatment of hypercapnic acidosis during infective exacerbations of COPD and other lung diseases.

看來permissive hypercapnia可能並不適用於所有的病患,尤其是那些對抗生素治療效果不佳的pneumonia induced ARDS。


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