SynthesisIntensive care medicine2022
The role of acute hypercapnia on mortality and short-term physiology in patients mechanically ventilated for ARDS: a systematic review and meta-analysis.
Synthesis in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effect of driving pressure-limiting strategies on outcomes of patients with ARDS: a meta-analysis of randomized controlled trials.Critical care (London, England) · 2026Pooled it
- Impact of ultra-low tidal volume ventilation on 1-year functional outcome in COVID-19 ARDS patients. A long-term follow-up analysis of a randomized controlled trial.Critical care (London, England) · 2026Trial
- Mechanical Power and the Association with Postoperative Impaired Oxygenation and Pulmonary Complications in Orthopedic Patients: Post Hoc Analysis of a Cluster Factorial Randomized Trial.Anesthesiology · 2026Trial
- Effects of PERMISSive lung-protective ventilation on outcome in critically ill, invasively ventilated patients (PERMISS): protocol for a feasibility and safety randomised clinical trial.BMJ open respiratory research · 2026Article
- Permissive hypercapnia in acute respiratory distress syndrome: physiological mechanisms and clinical implications.Medical gas research · 2026Article
- Assessment of mortality risk by respiratory rate-specific quartiles in mechanically ventilated patients with acute respiratory distress syndrome in Mexico.Internal and emergency medicine · 2026Observational
- PaCOJournal of clinical medicine · 2026Review
- Minimally invasive extracorporeal COCritical care (London, England) · 2026Observational
- Evolutive acid-base derangements in critically ill patients: epidemiological aspects, association with mortality and metabolic acidosis prediction.Critical care science · 2026Article
- The ribosomal landscape in influenza A virus infection: from molecular mechanisms to clinical relevance.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- PaCOFrontiers in medicine · 2026Review
- Individual and combined effects of chemical and mechanical power on postoperative pulmonary complications: a secondary analysis of the REPEAT study.Anaesthesia · 2025Article
- Sustained breath-holds in bronchoscopy: a pause worth taking?-a narrative review.Journal of thoracic disease · 2025Review
- Heart-Lung Interactions in Combined Distributive Shock and ARDS: Applied Cardiopulmonary Physiology at the Bedside.Journal of clinical medicine · 2025Review
- Application of tubeless anesthesia for enhanced recovery after thoracoscopic wedge resection of the lung: a randomized trial.Journal of thoracic disease · 2025Article
- Hypercapnia as a Double-Edged Modulator of Innate Immunity and Alveolar Epithelial Repair: A PRISMA-ScR Scoping Review.International journal of molecular sciences · 2025Article
- Sensing molecular carbon dioxide: a translational focus for respiratory disease.Physiological reviews · 2025Review
- Article
- ERS Congress 2024: highlights from the Respiratory Intensive Care Assembly.ERJ open research · 2025Article
- Anion gap predicting 90-Day mortality and guiding furosemide use in ARDS.Scientific reports · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHypercapnia is frequent during mechanical ventilation for acute respiratory distress syndrome (ARDS), but its effects on morbidity and mortality are still controversial. We conducted a systematic review and meta-analysis to explore clinical consequences of acute hypercapnia in adult patients ventilated for ARDS.
methodsWe searched Medline, Embase, and the Cochrane Library via the OVID platform for studies published from 1946 to 2021. "Permissive hypercapnia" defined hypercapnia in studies where the group with hypercapnia was ventilated with a protective ventilation (PV) strategy (lower V
resultsTwenty-nine studies (10,101 patients) were included. Permissive hypercapnia, imposed hypercapnia under PV, and imposed hypercapnia under NPV were reported in 8, 21 and 1 study, respectively. Studies testing permissive hypercapnia reported lower mortality in hypercapnic patients receiving PV as compared to non-hypercapnic patients receiving NPV: OR = 0.26, 95% CI [0.07-0.89]. By contrast, studies reporting imposed hypercapnia under PV reported increased mortality in hypercapnic patients receiving PV as compared to non-hypercapnic patients also receiving PV: OR = 1.54, 95% CI [1.15-2.07]. There was a significant interaction between the mechanism of hypercapnia and the effect on mortality.
conclusionsClinical effects of hypercapnia are conflicting depending on its mechanism. Permissive hypercapnia was associated with improved mortality contrary to imposed hypercapnia under PV, suggesting a major role of PV strategy on the outcome.
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