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Jun. 30, 2015
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CO2: Friend or Foe
Introduction
Carbon dioxide was a common vehicle of medical treatment in the first half of the previous century. Based on the research of Yandell Henderson and others, Carbogen was installed on fire trucks in New York City, Chicago, and other major American Cities. Physicians and firemen commonly used Carbogen to treat a wide variety of maladies including myocardial infarction, angina pectoris, stroke, asthma, influenza, pneumonia, carbon monoxide poisoning, smoke inhalation, drowning, and breathing problems in newborn babies. Anesthetists used CO2 supplementation to accelerate ether induction, optimize cardiorespiratory function, enhance morphine dosage to control surgical pain and stress, and prevent postoperative nausea, vomiting, atelectasis, and pneumonia. Unfortunately, they lacked capnography and pulse oximetry, and overenthusiastic CO2 supplementation during surgery occasionally caused asphyxiation disasters that were mistakenly attributed to “CO2 toxicity”. The resulting fear of CO2 caused it to be abandoned altogether until around 1990, when critical care physicians accidentally re-discovered its therapeutic effects while seeking better means to manage Adult Respiratory Distress Syndrome. They called it “permissive hypercarbia” and now use it routinely to manage critically ill patients. Modern research has subsequently confirmed that permissive hypercarbia enhances cardiac efficiency, cardiac output, oxygen uptake and distribution, tissue perfusion, and tissue oxygenation as well as lung protection and respiratory function. Meanwhile, modern anesthesia machines and monitoring have abolished the risk of CO2 asphyxiation. The enlightened use of CO2 supplementation with modern monitoring, equipment and research promises to revolutionize anesthetic technique and medical treatments. Nevertheless physicians in general and anesthesiologists in particular have thus far failed to re-embrace CO2 supplementation.

Aims and Scope:

1. CO2 supplementation during anesthesia to prevent postoperative atelectasis and pneumonia
2. CO2 supplementation to optimize opioid dosage and metabolism, optimize control of surgical nociception, and minimize morbidity and mortality in the immediate and distant aftermath of surgery
3. CO2 supplementation to treat myocardial infarction, angina pectoris, asthma, pneumonia, influenza, drowning, carbon monoxide poisoning, smoke inhalation, sepsis, and other medical conditions.
4. CO2 supplementation combined with opioids to treat sepsis, peritonitis, pneumonia, myocardial infarction, angina, trauma, and other maladies.
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