Hypercapnia

The PHY was first reported in 1965. By accident, Bendixen and his colleagues found that the children survived at pH values> 7.20 to 7.25, PaO2 normal, and PaCO2> 100 mm Hg. Since then, Darioli and Perret reported that PHY was used for the first time in patients with severe acute asthma, with a low respiratory rate of 6-10 times / min and a low tidal volume of 8-12 ml / kg to prevent PIP from exceeding 50 cmH2O and PaCO2 of 90 in children. mm Hg for 24 h, no life-threatening barotrauma was found, and all survived; in recent years, the use of PHY for ARDS has achieved satisfactory results, PIP <40 cmH2O, tidal volume 4-7ml / kg, PaCO2 maintained At 66.5 (38 to 158) mm Hg, occasionally above 120 mm Hg, the pH value of 7.26 (6.79 to 7.45) did not correct acidosis, and the incidence of complications was lower than expected. Tip PHY may improve prognosis. Adults with severe respiratory failure use low ventilation to maintain a high PaCO2, or PHY, to avoid lung damage. Can the same effect be used for premature babies? Two retrospective studies have shown that neonatal use of high-ventilation respiratory support, low levels of PaCO2 promote lung injury, increase the risk of cerebral hemorrhage and cerebral palsy, and conversely a range of hypercapnia can reduce this complication. However, due to lack of clinical awareness of PHY and concerns about side effects, it has not been used in clinical practice. It was not until 1995 that Jobe's prospective trial and the recommendations of some authors began to apply it in pediatrics.

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