Abstract
Dead space in acute respiratory distress syndrome: more than a feeling!
Highlights
Why clinicians are slow to implement advances in diagnosis and treatment from well-designed clinical trials is a continuously debated question in critical care
Dead space is measured at the bedside by volumetric capnography, which reports expired CO2 elimination as a function of expired tidal volume (VT), and VD/VTphys is calculated using the Enghoff’s modification of Bohr’s original equation: VD/VTphys = (PaCO2 – PECO2)/PaCO2, where PaCO2 is the arterial partial pressure of CO2 obtained by arterial blood sampling and PECO2 is an estimate of mixed expired partial pressure of CO2 obtained from the mid-portion of phase III of the
Over 40 years ago, Suter et al [4] pointed out that increasing positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS) augments blood oxygenation and decreases shunt. They used the maximum level of oxygen transport to determine the optimum levels of PEEP, they showed that maximizing total compliance and minimizing physiologic dead space (VD/VTphys) yielded the best results
Summary
Why clinicians are slow to implement advances in diagnosis and treatment from well-designed clinical trials is a continuously debated question in critical care. * Correspondence: lblanch@tauli.cat 1Critical Care Center, Hospital de Sabadell, Corporació Sanitària Universitària ParcTaulí, Universitat Autònoma de Barcelona, c. Spain 2CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain Full list of author information is available at the end of the article volumetric capnogram [2, 3].
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