Importance of carbon dioxide in the critical patient:

Medicina intensiva · May 2019

Review

Importance of carbon dioxide in the critical patient: Implications at the cellular and clinical levels.

Important recent insights have emerged regarding the cellular and molecular role of carbon dioxide (CO2) and the effects of hypercapnia. The latter may have beneficial effects in patients with acute lung injury, affording reductions in pulmonary inflammation, lessened oxidative alveolar damage, and the regulation of innate immunity and host defenses by inhibiting the expression of inflammatory cytokines. ⋯ Clearly, hypercapnia has both beneficial and harmful consequences, and it is important to determine the net effect under specific conditions. The purpose of this review is to describe the immunological and physiological effects of carbon dioxide, considering their potential consequences in patients with acute respiratory failure.

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- Luis Morales Quinteros, Josep Bringué Roque, David Kaufman, and Antonio Artigas Raventós.
- Servicio de Medicina Intensiva, Hospital Universitario Sagrat Cor, Barcelona, España. Electronic address: luchomq2077@gmail.com.
- Med Intensiva. 2019 May 1; 43 (4): 234-242.
AbstractImportant recent insights have emerged regarding the cellular and molecular role of carbon dioxide (CO2) and the effects of hypercapnia. The latter may have beneficial effects in patients with acute lung injury, affording reductions in pulmonary inflammation, lessened oxidative alveolar damage, and the regulation of innate immunity and host defenses by inhibiting the expression of inflammatory cytokines. However, other studies suggest that CO2 can have deleterious effects upon the lung, reducing alveolar wound repair in lung injury, decreasing the rate of reabsorption of alveolar fluid, and inhibiting alveolar cell proliferation. Clearly, hypercapnia has both beneficial and harmful consequences, and it is important to determine the net effect under specific conditions. The purpose of this review is to describe the immunological and physiological effects of carbon dioxide, considering their potential consequences in patients with acute respiratory failure.Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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Importance of carbon dioxide in the critical patient: Implications at the cellular and clinical levels.

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