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10.4187/respcare.08061 http://scihub22266oqcxt.onion/10.4187/respcare.08061 32636278!ä!32636278 Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=32636278&cmd=llinks): Failed to open stream: HTTP request failed! 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End-Tidal-to-Arterial P(CO(2)) Ratio as Signifier for Physiologic Dead-Space Ratio and Oxygenation Dysfunction in Acute Respiratory Distress Syndrome |pdf=|usr=}}{{32636278}} gab.com Text End-Tidal-to-Arterial P(CO(2)) Ratio as Signifier for Physiologic Dead-Space Ratio and Oxygenation Dysfunction in Acute Respiratory Distress Syndrome JO: Respir Care http://www.kidney.de/pget.php?&tw=1&pmid=32636278 #FOAvip BACKGROUND: The ratio of end-tidal CO(2) pressure to arterial partial pressure of CO(2) ([Formula: see text]) was recently suggested for monitoring pulmonary gas exchange in patients with ARDS associated with COVID-19, yet no evidence was offered supporting that claim. Therefore, we evaluated whether [Formula: see text] might be relevant in assessing ARDS not associated with COVID-19. METHODS: We evaluated the correspondence between [Formula: see text] and the ratio of dead space to tidal volume (V(D)/V(T)) measured in 561 subjects with ARDS from a previous study in whom [Formula: see text] data were also available. Subjects also were analyzed according to 4 ranges of [Formula: see text] representing increasing illness severity (>/= 0.80, 0.6-0.79, 0.50-0.59, and < 0.50). Correlation was assessed by either Pearson or Spearman tests, grouped comparisons were assessed using either ANOVA or Kruskal-Wallis tests and dichotomous variables assessed by Fisher Exact tests. Normally distributed data are presented as mean and standard deviation(SD) and non-normal data are presented as median and inter-quartile range (IQR). Overall mortality risk was assessed with multivariate logistic regression. Alpha was set at 0.05. RESULTS: [Formula: see text] correlated strongly with V(D)/V(T) (r = -0.87 [95% CI -0.89 to -0.85], P < .001). Decreasing [Formula: see text] was associated with increased V(D)/V(T) and hospital mortality between all groups. In the univariate analysis, for every 0.01 decrease in [Formula: see text], mortality risk increased by approximately 1% (odds ratio 0.009, 95% CI 0.003-0.029, P < .001) and maintained a strong independent association with mortality risk when adjusted for other variables (odds ratio 0.19, 95% CI 0.04-0.91, P = .039). [Formula: see text] < 0.50 was characterized by very high mean +/- SD value for V(D)/V(T) (0.82 +/- 0.05, P < .001) and high hospital mortality (70%). CONCLUSIONS: Using [Formula: see text] as a surrogate for V(D)/V(T) may be a useful and practical measurement for both management and ongoing research into the nature of ARDS. Twit Text FOAVip End-Tidal-to-Arterial P(CO(2)) Ratio as Signifier for Physiologic Dead-Space Ratio and Oxygenation Dysfunction in Acute Respiratory Distress Syndrome ????Respir Care http://www.kidney.de/pget.php?&tw=1&pmid=32636278 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32636278 #FOAvip English Wikipedia <ref>{{Cite pmid|32636278}}</ref> End-Tidal-to-Arterial P(CO(2)) Ratio as Signifier for Physiologic Dead-Space Ratio and Oxygenation Dysfunction in Acute Respiratory Distress Syndrome #MMPMID32636278 Kallet RH; Lipnick MS Respir Care 2021[Feb]; 66 (2): 263-268 PMID32636278show ga BACKGROUND: The ratio of end-tidal CO(2) pressure to arterial partial pressure of CO(2) ([Formula: see text]) was recently suggested for monitoring pulmonary gas exchange in patients with ARDS associated with COVID-19, yet no evidence was offered supporting that claim. Therefore, we evaluated whether [Formula: see text] might be relevant in assessing ARDS not associated with COVID-19. METHODS: We evaluated the correspondence between [Formula: see text] and the ratio of dead space to tidal volume (V(D)/V(T)) measured in 561 subjects with ARDS from a previous study in whom [Formula: see text] data were also available. Subjects also were analyzed according to 4 ranges of [Formula: see text] representing increasing illness severity (>/= 0.80, 0.6-0.79, 0.50-0.59, and < 0.50). Correlation was assessed by either Pearson or Spearman tests, grouped comparisons were assessed using either ANOVA or Kruskal-Wallis tests and dichotomous variables assessed by Fisher Exact tests. Normally distributed data are presented as mean and standard deviation(SD) and non-normal data are presented as median and inter-quartile range (IQR). Overall mortality risk was assessed with multivariate logistic regression. Alpha was set at 0.05. RESULTS: [Formula: see text] correlated strongly with V(D)/V(T) (r = -0.87 [95% CI -0.89 to -0.85], P < .001). Decreasing [Formula: see text] was associated with increased V(D)/V(T) and hospital mortality between all groups. In the univariate analysis, for every 0.01 decrease in [Formula: see text], mortality risk increased by approximately 1% (odds ratio 0.009, 95% CI 0.003-0.029, P < .001) and maintained a strong independent association with mortality risk when adjusted for other variables (odds ratio 0.19, 95% CI 0.04-0.91, P = .039). [Formula: see text] < 0.50 was characterized by very high mean +/- SD value for V(D)/V(T) (0.82 +/- 0.05, P < .001) and high hospital mortality (70%). CONCLUSIONS: Using [Formula: see text] as a surrogate for V(D)/V(T) may be a useful and practical measurement for both management and ongoing research into the nature of ARDS. |*Respiratory Dead Space[MESH] |Arterial Pressure[MESH] |COVID-19[MESH] |Carbon Dioxide/*blood[MESH] |Humans[MESH] |Partial Pressure[MESH] |Respiratory Distress Syndrome/diagnosis/*physiopathology[MESH]End-Tidal-to-Arterial P(CO(2)) Ratio as Signifier for Physiologic Dead(epmc).pdf DeepDyve Pubget Overpricing