permissive hypercapnia
A lung-protective ventilation strategy that accepts elevated carbon dioxide levels to minimize ventilator-induced lung injury in pediatric patients with acute respiratory failure.
Full Definition
Permissive hypercapnia is a deliberate ventilation strategy that allows carbon dioxide levels to rise above normal physiologic ranges (typically accepting PaCO2 values of 50-80 mmHg or higher) to avoid high airway pressures and volumes that could cause ventilator-induced lung injury. This approach is particularly important in pediatric patients with conditions such as acute respiratory distress syndrome (ARDS) or severe asthma, where aggressive ventilation attempts may worsen lung injury. The strategy prioritizes lung protection over normalization of blood gases, accepting the mild respiratory acidosis that accompanies elevated CO2 levels while monitoring for adverse effects such as increased intracranial pressure or severe acidemia.
In Context
- "The team implemented a permissive hypercapnia strategy, accepting a PaCO2 of 65 mmHg to maintain lung-protective ventilation." — Critical care management plan
- "Permissive hypercapnia was contraindicated due to the patient's concurrent traumatic brain injury." — Clinical decision note