TAILIEUCHUNG - Báo cáo y học: " Can ‘permissive’ hypercapnia modulate the severity of sepsis-induced ALI/ARDS"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Can ‘permissive’ hypercapnia modulate the severity of sepsis-induced ALI/ARDS? | Curley et al. Critical Care 2011 15 212 http content 15 2 212 CRITICAL CARE REVIEW L_ Can permissive hypercapnia modulate the severity of sepsis-induced ALI ARDS Gerard Curley Mairead Hayes and John G Laffey This article is one of eleven reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2011 Springer Verlag and co-published as a series in Critical Care. Other articles in the series can be found online at http series annual. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http series 8901 Introduction Ventilatory strategies that reduce lung stretch by reducing tidal and minute ventilation which results in a permissive hypercapnic acidosis improve outcome in patients with acute lung injury acute respiratory distress syndrome ALI ARDS 1 2 . Reassuringly evidence from clinical studies attests to the safety and lack of detrimental effects of hypercapnic acidosis 2 . Of particular importance a secondary analysis of data from the ARDSnet tidal volume study 1 demonstrated that the presence of hypercapnic acidosis at the time of randomization was associated with improved patient survival in patients who received high tidal volume ventilation 3 . These findings have resulted in a shift in paradigms regarding hypercapnia - from avoidance to tolerance -with hypercapnia increasingly permitted in order to realize the benefits of low lung stretch. Consequently low tidal and minute volume ventilation and the accompanying permissive hypercapnia are now the standard of care for patients with ALI ARDS and are increasingly used in the ventilatory management of a diverse range of diseases leading to acute severe respiratory failure including asthma and chronic obstructive pulmonary disease. The inflammatory response plays a central role in the pathogenesis of injury and in the repair process in ALI ARDS 4 . Inflammation is a highly conserved process in .

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