Hypercapnia and hypercapnic acidosis in sepsis: harmful, beneficial or unclear?

Hypercapnia and hypercapnic acidosis in sepsis: harmful, beneficial or unclear?
Crit Care Resusc. 2018 Jun;20(2):94-100
Authors: Tiruvoipati R, Gupta S, Pilcher D, Bailey M
Abstract
Mortality related to sepsis among critically ill patients remains high. Recent literature suggests that hypercapnia may affect the pathophysiology of sepsis. The effects of hypercapnia on sepsis are largely related to the direct effect of hypercapnic acidosis on immune function and, as a consequence, of increased cardiac output that subsequently leads to improved tissue oxygenation. Appropriate management of hypercapnia may aid in improving the outcomes of sepsis. Our aim was to review the effects of compensated hypercapnia and hypercapnic acidosis on sepsis, with a specific focus on critically ill patients. Hypercapnic acidosis has been extensively studied in various in vivo animal models of sepsis and ex vivo studies. Published data from animal experimental studies suggest that the effects of hypercapnic acidosis are variable, with benefit shown in some settings of sepsis and harm in others. The effects may also vary at different time points during the course of sepsis. There are very few clinical studies investigating the effects of hypercapnia in prevention of sepsis and in established sepsis. It appears from these very limited clinical data that hypercapnia may be associated with adverse outcomes. There are no clinical studies investigating clinical ...

Source: Critical Care and Resuscitation - June 3, 2018 Category: Intensive Care Tags: Crit Care Resusc Source Type: research