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Critical Care
Published in: Critical Care 1/2016

Open Access 01-12-2016 | Commentary

Ultra-protective ventilation and hypoxemia

Author: Luciano Gattinoni

Published in: Critical Care | Issue 1/2016

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Abstract

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.
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Metadata
Title
Ultra-protective ventilation and hypoxemia
Author
Luciano Gattinoni
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2016
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-016-1310-9

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