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Abstract
PURPOSE: We observed a consistent paradoxical reduction of arterial pCO2 in patients with Adult Respiratory Distress Syndrome (ARDS) whenever we minimized minute ventilation with respiratory rates as low as 5/min using 4:1 inverse inspiratory/expiratory (I:E) mode ventilation. This effect was counter-intuitive and its magnitude was a qualitative departure from behavior anticipated by deadspace timing effects or other ventilation/perfusion (V/Q) mechanisms. We wondered whether incomplete CO2 equilibration between the end-capillary and gas-containing compartments could account for our observation.
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