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Editorial
. 2017 Jun;9(6):1420-1425.
doi: 10.21037/jtd.2017.05.69.

Hypercapnia during acute respiratory distress syndrome: the tree that hides the forest!

Xavier Repessé  1 , Antoine Vieillard-Baron  1   2   3
Affiliations
Editorial

Hypercapnia during acute respiratory distress syndrome: the tree that hides the forest!

Xavier Repessé et al. J Thorac Dis. 2017 Jun.
No abstract available

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Timescale of the evolution of therapeutic strategies in ARDS and their link with observed mortality, PaCO2 and right ventricular failure. ARDS, acute respiratory distress syndrome; drivP, driving pressure; ECCO2R, extra-corporeal CO2 removal; LPV, lung protective ventilation; PH, pulmonary hypertension; PP, prone position; RCT, randomized controlled trial; RV, right ventricle; TV, tidal volume; VILI, volume induced lung injury.
Figure 2
Figure 2
Effect of a fast change in PaCO2 (90 minutes) on the right ventricle in a patient ventilated for severe ARDS. Note that between the 2 conditions, one with very severe hypercapnia (panel A), the other with a limited hypercapnia, plateau pressure, as well as oxygenation, were the same and driving pressure was lower in panel A. In panel A, a short axis view of the left ventricle by a transgastric approach visualized a dilated right ventricle with a septal flattening while in panel B no more RV failure is observed. ARDS, acute respiratory distress syndrome; LV, left ventricle; Pplat, plateau pressure; RV, right ventricle.
See this image and copyright information in PMC

Comment on

  • Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome.
    Nin N, Muriel A, Peñuelas O, Brochard L, Lorente JA, Ferguson ND, Raymondos K, Ríos F, Violi DA, Thille AW, González M, Villagomez AJ, Hurtado J, Davies AR, Du B, Maggiore SM, Soto L, D'Empaire G, Matamis D, Abroug F, Moreno RP, Soares MA, Arabi Y, Sandi F, Jibaja M, Amin P, Koh Y, Kuiper MA, Bülow HH, Zeggwagh AA, Anzueto A, Sznajder JI, Esteban A; VENTILA Group. Nin N, et al. Intensive Care Med. 2017 Feb;43(2):200-208. doi: 10.1007/s00134-016-4611-1. Epub 2017 Jan 20. Intensive Care Med. 2017. PMID: 28108768 Free PMC article.

References

    1. Nin N, Muriel A, Peñuelas O, et al. Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome. Intensive Care Med 2017;43:200-8. 10.1007/s00134-016-4611-1 - DOI - PMC - PubMed
    1. Esteban A, Anzueto A, Frutos F, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 2002;287:345-55. 10.1001/jama.287.3.345 - DOI - PubMed
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    1. ARDS Definition Task Force ., Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA 2012;307:2526-33. - PubMed

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