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Titolo:
PERMISSIVE HYPERCAPNIA - A NEW STRATEGY I N THE TREATMENT OF SEVERE RESPIRATORY-FAILURE
Autore:
PERRET C; FEIHL F;
Indirizzi:
CHU VAUDOIS,SERV SOINS INTENS MED CH-1011 LAUSANNE SWITZERLAND
Titolo Testata:
Bulletin de l'Academie nationale de medecine
fascicolo: 1, volume: 179, anno: 1995,
pagine: 185 - 197
SICI:
0001-4079(1995)179:1<185:PH-ANS>2.0.ZU;2-6
Fonte:
ISI
Lingua:
FRE
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
NO
Recensione:
Indirizzi per estratti:
Citazione:
C. Perret e F. Feihl, "PERMISSIVE HYPERCAPNIA - A NEW STRATEGY I N THE TREATMENT OF SEVERE RESPIRATORY-FAILURE", Bulletin de l'Academie nationale de medecine, 179(1), 1995, pp. 185-197

Abstract

Permissive hypercapnia (PHY) represents an interesting approach in critically ill ventilated patients, because it allows to ensure adequategas exchange while avoiding the adverse effects related to excessive airway pressures. Its objective is to improve oxygenation while reducing the risk of barotrauma and circulatory impairment. This concept is all the more important when considering that in majority of lung diseases for which MV is applied, lung involvement is highly inhomogeneous,meaning that the functionally normal or near normal areas are the most exposed to the deleterious effects of overdistension. Undesired physiological effects of non massive respiratory acidosis (PaCO2 less thanor equal to 80 mmHg, arterial pH greater than or equal to 7.15) are reversible and mostly minor. This good tolerance legitimates two strategies : firstly to accept hypercapnia in conditions such as acute severe asthma for which enforced normalization of PaCO2 would imply potentially lethal complications, and secondly to deliberately induce respiratory acidosis while using very low airway pressures and alveolar ventilation to limit or prevent overdistension lung damage in injured as well as in normal areas. When the cerebral vasodilation induced by CO2 might aggravate a preexisting intracranial disorder, PHY is obviously contraindicated.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 02:32:07