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10.4187/respcare.08061

http://scihub22266oqcxt.onion/10.4187/respcare.08061
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32636278!ä!32636278

suck abstract from ncbi


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pmid32636278      Respir+Care 2021 ; 66 (2): 263-268
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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 #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]


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