- 期刊
二氧化碳在肺循環系統及呼吸系統的效應
Effects of Carbon Dioxide on the Pulmonary Circulatory System and the Respiratory System
摘要
二氧化碳（carbon dioxide, CO_2）除了是一種大氣氣體，也是我們身體的代謝產物。它對我們的生理影響一直以來並不太被重視。近年來，許多的研究學者提出「治療性高碳酸血症」（therapeutic hypercapnia）的理論，他們的研究顯示在吸入氣體中添加2%～10%二氧化碳造成高碳酸血症具有肺臟保護效應。除了吸入性二氧化碳治療的開發應用，另一個值得關注的議題是－ 在臨床呼吸治療，呼吸器設定的方式會影響到每分鐘通氣量，進而間接地影響到二氧化碳在血液中的值。除了新生兒持續性肺高壓症、小兒先天性心臟病術後及創傷性腦損傷患者的機械通氣（mechanical ventilation）照護，「可允許性高碳酸血症」（permissive hypercapnia）肺臟保護通氣策略，在臨床也被廣泛地使用在急性呼吸窘迫症（acute respiratory distress syndrome, ARDS）及嚴重性肺損傷之症狀。二氧化碳的生理效應及臨床治療應用，需更清楚地被明白，才能擬定適合重症病患的照護及通氣策略。本綜合論述回顧了跟二氧化碳相關的動物及臨床研究報告，統整二氧化碳在肺循環系統及呼吸系統的生理病理效應。
並列摘要
In addition to being an atmospheric gas, carbon dioxide (CO2) is also a metabolic by-product of our bodies. Its effects on our physiology have historically been underestimated, but respiratory therapy involving the use of CO2 is now becoming common. For example, in recent years many researchers have shown that that adding two to ten percent carbon dioxide to inhaled gas to cause hypercapnia ("therapeutic hypercapnia") has a lung protective effect. Another type of respiratory therapy involving CO2 is clinical respiratory therapy. In this therapy, the ventilator setting controls minute changes in ventilation which then indirectly affects the amount of carbon dioxide in the blood. In addition to neonatal persistent pulmonary hypertension, pediatric congenital heart surgery and traumatic brain injury patients with specific mechanical ventilation, the lung protection ventilation strategy, permissive hypercapnia is also widely used clinically in the symptoms of acute respiratory distress syndrome (ARDS) and severe lung injury. In this comprehensive review of animal and clinical research related to CO2 therapy, we summarize both the physiological and pathological effects of carbon dioxide on the pulmonary circulatory system and the respiratory system. However, the physiological effects and clinical application of CO2 need to be more clearly understood in order to develop suitable care and ventilation strategies for severe patients.