Publication

Hypercapnia and acidosis in sepsis

Curley, Gerard
; 
Contreras, Maya
; 
Nichol, Alistair D.
; 
Higgins, Brendan D.
; 
Laffey, John G.
Identifiers
http://hdl.handle.net/10379/10991
https://doi.org/10.13025/28500
Repository DOI
10.1097/aln.0b013e3181ca361f
Publication Date
2010-02-01
Keywords
acute lung injury, respiratory-distress-syndrome, carbon-dioxide, human-neutrophils, united-states, in-vitro, therapeutic hypercapnia, inflammatory response, bacterial pneumonia, intracellular ph
Type
Article
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Citation
Curley, Gerard; Contreras, Maya; Nichol, Alistair D. Higgins, Brendan D.; Laffey, John G. (2010). Hypercapnia and acidosis in sepsis. Anesthesiology 112 (2), 462-472
Abstract
Acute respiratory distress syndrome is a devastating disease that causes substantial morbidity and mortality. Mechanical ventilation can worsen lung injury, whereas ventilatory strategies that reduce lung stretch, resulting in a "permissive" hypercapnic acidosis (HCA), improve outcome. HCA directly reduces nonsepsis-induced lung injury in preclinical models and, therefore, has therapeutic potential in these patients. These beneficial effects are mediated via inhibition of the host immune response, particularly cytokine signaling, phagocyte function, and the adaptive immune response. Of concern, these immunosuppressive effects of HCA may hinder the host response to microbial infection. Recent studies suggest that HCA is protective in the earlier phases of bacterial pneumonia-induced sepsis but may worsen injury in the setting of prolonged lung sepsis. In contrast, HCA is protective in preclinical models of early and prolonged systemic sepsis.. Buffering of the HCA is not beneficial and may worsen pneumonia-induced injury.
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Publisher
Ovid Technologies (Wolters Kluwer Health)
Publisher DOI
Rights
Attribution-NonCommercial-NoDerivs 3.0 Ireland
cbn
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Externally hosted open access publications with University of Galway authors (2)