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2016 ; 20
(1
): 130
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Ultra-protective ventilation and hypoxemia
#MMPMID27170273
Gattinoni L
Crit Care
2016[May]; 20
(1
): 130
PMID27170273
show ga
Partial extracorporeal CO2 removal allows a decreasing tidal volume without
respiratory acidosis in patients with acute respiratory distress syndrome. This,
however, may be associated with worsening hypoxemia, due to several mechanisms,
such as gravitational and reabsorption atelectasis, due to a decrease in mean
airway pressure and a critically low ventilation-perfusion ratio, respectively.
In addition, an imbalance between alveolar and artificial lung partial pressures
of nitrogen may accelerate the process. Finally, the decrease in the respiratory
quotient, leading to unrecognized alveolar hypoxia and monotonous low plateau
pressures preventing critical opening, may contribute to hypoxemia.