Menitove S M, Goldring R M
Am J Med. 1983 May;74(5):898-901. doi: 10.1016/0002-9343(83)91082-3.
Management of intubated hypercapnic asthmatic patients requires a delicate balance between the control of pH with adequate ventilation and the risk of barotrauma associated with the high pressures that may be required. The present report documents a strategy of mechanical ventilation combined with infusion of large amounts of bicarbonate in three patients with severe status asthmaticus requiring intubation. This strategy reduced peak inflation pressure by decreasing ventilation and maintained a physiologic pH while allowing pCO2 to remain elevated.
对于插管的高碳酸血症哮喘患者的管理，需要在通过充分通气控制pH值与可能需要的高压相关的气压伤风险之间取得微妙的平衡。本报告记录了在三名需要插管的重度哮喘持续状态患者中，机械通气与输注大量碳酸氢盐相结合的策略。该策略通过减少通气降低了峰值充气压力，并在允许pCO2保持升高的同时维持了生理pH值。
