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Vol. 46. Issue 7.
Pages 378-382 (July 2010)
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Vol. 46. Issue 7.
Pages 378-382 (July 2010)
Review Article
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Permissive and Non-permissive Hypercapnia: Mechanisms of Action and Consequences of High Carbon Dioxide Levels
Hipercapnia permisiva o no permisiva: mecanismos de acción y consecuencias de altos niveles de dióxido de carbono
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Arturo Brivaa,
Corresponding author
, Emilia Lecuonab, Jacob I. Sznajderb
a Medicina Intensiva, Departamento de Fisiopatología, Hospital de Clínicas, Montevideo, Uruguay
b Department of Medicine, Pulmonary Division, Feinberg School of Medicine, Northwestern University, Chicago, United States
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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.

Keywords:
Acute lung injury
Hypercapnia
Lung damage
Resumen

La lesión pulmonar aguda es una enfermedad con alta mortalidad, que afecta a gran cantidad de pacientes y cuyo tratamiento continúa en debate. Recientemente, se ha postulado que la hipercapnia podría atenuar la respuesta inflamatoria durante la lesión pulmonar, lo que le otorgaría un papel específico dentro de las estrategias de protección pulmonar durante la asistencia respiratoria mecánica. En el presente trabajo revisamos la evidencia actual sobre el papel que altos niveles de CO2 en sangre desempeñan en la lesión pulmonar. Concluimos que, si bien existen reportes que demuestran beneficios, evidencia más reciente sugiere que la hipercapnia puede ser nociva, contribuyendo a agravar el daño pulmonar.

Palabras clave:
Lesion pulmonar aguda
Hipercapnia
Daño pulmonar
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