However, more recent studies have reported that hypercapnia has harmful effects, including impairment of alveolar epithelial function, cell proliferation, and muscle function as well as of neutrophil function and innate immunity. It was even suggested that “therapeutic hypercapnia” might be beneficial. Also, in experimental models of sepsis-induced acute lung injury there were reports of the beneficial effects of hypercapnic acidosis. 40 ± 10 mmHg), probably due to higher respiratory rates in that group. In the ARDS Network Study comparing low and high tidal volumes, patients in the low tidal volume group had only mild changes in PaCO 2 (35 ± 8 vs. In the early 1990s the concept of permissive hypercapnia was proposed for patients with acute lung injury. However, this strategy can sometimes result in high partial pressure of carbon dioxide in arterial blood (PaCO 2) levels. Limitation of tidal volumes and airway pressure is now used as a lung protective strategy during MV in patients with ARDS. reported that during MV of acute respiratory distress syndrome (ARDS), limitation of airway pressure to <30 cmH 2O was associated with lower mortality in patients with acute lung injury. Mechanical ventilation (MV) with high tidal volumes has been shown to both cause and worsen lung injury.
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