CrossTalk proposal: There is added benefit to providing permissive hypercapnia in the treatment of ARDS

摘要

The term 'permissive hypercapnia' was coined after two case series by Hickling and colleagues in the early 1990s that suggested that limitation of airway pressure and tidal volume, with a tolerant approach to elevations in arterial CO2, was associated with lower hospital mortality than predicted by 'acute physiological and chronic health evaluation (APACHE) II' scores (Hickling et al 1990, 1994). In fact directly analogous findings had been reported in the mid 1980s, whereby lowering tidal volumes in status asthmaticus (Darioli & Perret, 1984) and in persistent pulmonary hypertension of the newborn (Wung et al. 1985) was associated with hypercapnia and an apparent improvement in survival.