Ventilatory ratio: validation in an ex vivo model and analysis in ARDS/ALI patients

P Sinha,N Soni,Jg Hardman,A Bersten,K Corrie

doi:10.1186/cc9599

Abstract

Several indices exist to monitor adequate oxygenation, but no such index exists for ventilatory efficiency. The ventilatory ratio (VR) is a simple tool to monitor changes in ventilatory efficiency using variables commonly measured at the bedside [1]: VR = V˙Emeasured×Paco2 measured V˙Epredicted×Paco2 predicted See Figure Figure11 overleaf (where predicted values are VE 100 ml/kg/minute and PaCO2 5 kPa). Figure 1 Chi-squared test for trends P = 0.0015. Methods The Nottingham Physiology Simulator (NPS), a validated computational model of cardiopulmonary physiology [2], was used to validate the ability of VR to reflect ventilatory efficiency ex vivo. Three virtual patients were configured, representing healthy lung, ARDS and COPD. VR was calculated while minute ventilation, ventilation rate and VCO2 were each varied in isolation. The clinical uses of VR were then examined in a database comprising 122 patients with ALI and ARDS [3]. Standard respiratory data and VR values were analysed in all patients.

Highlights

In this study we aimed to investigate the relationship between thyroid hormone abnormalities and major cardiovascular events and sudden cardiac death at 3 and 6 months after discharge in patients who were admitted to the Emergency Department with acute coronary syndrome
The aim of this study was to demonstrate the role of arginase and adenosine deaminase (ADA) in patients suffering from myocardial infarction (MI), and in a group of patients with chronic renal failure (CRF) with cardiovascular diseases (CVD)
ADA may be considered good diagnostic enzymes in patients suffering from MI, and ADA for patients with CRF with CVD

Summary

Introduction

Results We studied 53 patients (42 males, mean age (SEM) 57.6 (2.8) years, illness severity scores APACHE II 21.3 (0.9); SAPS II 53.3 (2.3); SOFA 10.2 (0.2); and ICU stay 35.9 (4.8) days). Results We included 53 consecutive patients (42 males, mean age 57.6 ± 2.8 years, illness severity scores APACHE II 21.3 ± 0.9; SAPS II 53.3 ± 2.3; SOFA 10.2 ± 0.2; and mean ICU stay 35.9 ± 4.8 days) of which 25 (47.2%) had at least one US findings. The objective of this study was to determine the incidence and type of incidents related to intrahospital transport (IHT) of critically ill patients in our ICU and to identify contributing factors of these incidents. The aim of this study was to assess the effect of monotherapy with nebulized colistin on clinical and microbiological outcomes in critically ill patients with VAT due to polymyxin-only susceptible Gram-negative bacteria

Objectives

Methods

Results

Conclusion