Morales Quinteros Luis, Bringué Roque Josep, Kaufman David, Artigas Raventós Antonio
Servicio de Medicina Intensiva, Hospital Universitario Sagrat Cor, Barcelona, España.
Universidad Autónoma de Barcelona, Sabadell, Barcelona, España.
Med Intensiva (Engl Ed). 2019 May;43(4):234-242. doi: 10.1016/j.medin.2018.01.005. Epub 2018 Feb 24.
Important recent insights have emerged regarding the cellular and molecular role of carbon dioxide (CO) and the effects of hypercapnia. The latter may have beneficial effects in patients with acute lung injury, affording reductions in pulmonary inflammation, lessened oxidative alveolar damage, and the regulation of innate immunity and host defenses by inhibiting the expression of inflammatory cytokines. However, other studies suggest that CO can have deleterious effects upon the lung, reducing alveolar wound repair in lung injury, decreasing the rate of reabsorption of alveolar fluid, and inhibiting alveolar cell proliferation. Clearly, hypercapnia has both beneficial and harmful consequences, and it is important to determine the net effect under specific conditions. The purpose of this review is to describe the immunological and physiological effects of carbon dioxide, considering their potential consequences in patients with acute respiratory failure.
最近出现了关于二氧化碳（CO）的细胞和分子作用以及高碳酸血症影响的重要见解。后者可能对急性肺损伤患者有有益影响，可减轻肺部炎症、减轻肺泡氧化损伤，并通过抑制炎性细胞因子的表达来调节固有免疫和宿主防御。然而，其他研究表明，CO可对肺产生有害影响，减少肺损伤时的肺泡伤口修复、降低肺泡液重吸收速率，并抑制肺泡细胞增殖。显然，高碳酸血症既有有益后果也有有害后果，确定特定条件下的净效应很重要。本综述的目的是描述二氧化碳的免疫和生理作用，并考虑其在急性呼吸衰竭患者中的潜在后果。
