Permissive and Non-permissive Hypercapnia: Mechanisms of Action and Consequences of High Carbon Dioxide Levels |
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| Authors: | Arturo Briva Emilia Lecuona Jacob I Sznajder |
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| Institution: | 1. Medicina Intensiva, Departamento de Fisiopatología, Hospital de Clínicas, Montevideo, Uruguay;2. Department of Medicine, Pulmonary Division, Feinberg School of Medicine, Northwestern University, Chicago, United States;1. Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil;2. Laboratory of Medical Investigation 8, Posgraduate Program in Anesthesiology, Medical School, University of São Paulo, São Paulo, Brazil;1. Departamento de Estadística, Universidad Autónoma de Aguascalientes, Aguascalientes 20131, Mexico;2. Departamento de Matemáticas y Física, Universidad Autónoma de Aguascalientes, Aguascalientes 20131, Mexico;1. Centro Universitário do Triângulo, Uberlândia, Brazil;2. Universidade de São Paulo, Ribeirão Preto, Brazil;3. Universidade Federal de São Paulo, São Paulo, Brazil;3. Division of Pulmonary and Critical Care Medicine, Northwestern University, Chicago, Illinois 60611;4. Departamento de Fisiopatología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay;5. Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden;6. Pulmonology Department-Muscle and Respiratory System Research Unit, Molecular Mechanisms of Lung Cancer Predisposition Research Group (IMIM)-Hospital del Mar-IMIM, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, The Barcelona Biomedical Research Park, Barcelona, Spain;12. McAllister Heart Institute, University of North Carolina, Chapel Hill, North Carolina;1. Laboratory of Respiratory Physiology, Pavlov Institute of Physiology of RAS, nab. Makarova 6, 199034 St.-Petersburg, Russia;2. Department of Anatomy and Physiology of Humans and Animals, Herzen State Pedagogical University of Russia, St.-Petersburg, Russia;3. From the Department of Animal Biology and Marie Lowe Center for Comparative Oncology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6046;4. the Department of Biochemistry and Center in Molecular Toxicology, School of Medicine, Vanderbilt University, Nashville, Tennessee 37232-0146 |
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| Abstract: | Acute lung injury is a disease with high mortality, which affects a large numbers of patients whose treatment continues to be debated. It has recently been postulated that hypercapnia can attenuate the inflammatory response during lung injury, which would assign it a specific role within lung protection strategies during mechanical ventilation. In this paper, we review current evidence on the role that high levels of CO2 in the blood play in lung injury. We conclude that, although there are reports that show benefits, the most recent evidence suggests that hypercapnia can be harmful and can contribute to worsening lung damage. |
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