Estimated dead space fraction and the ventilatory ratio are associated with mortality in early ARDS.
ARDS
Acute respiratory distress syndrome
Dead space
Intensive care unit
Mortality
Prediction
Prognostication
Respiratory dead space
Ventilatory ratio
Journal
Annals of intensive care
ISSN: 2110-5820
Titre abrégé: Ann Intensive Care
Pays: Germany
ID NLM: 101562873
Informations de publication
Date de publication:
21 Nov 2019
21 Nov 2019
Historique:
received:
29
07
2019
accepted:
05
11
2019
entrez:
23
11
2019
pubmed:
23
11
2019
medline:
23
11
2019
Statut:
epublish
Résumé
Indirect indices for measuring impaired ventilation, such as the estimated dead space fraction and the ventilatory ratio, have been shown to be independently associated with an increased risk of mortality. This study aimed to compare various methods for dead space estimation and the ventilatory ratio in patients with acute respiratory distress syndrome (ARDS) and to determine their independent values for predicting death at day 30. The present study is a post hoc analysis of a prospective observational cohort study of ICUs of two tertiary care hospitals in the Netherlands. Individual patient data from 940 ARDS patients were analyzed. Estimated dead space fraction and the ventilatory ratio at days 1 and 2 were significantly higher among non-survivors (p < 0.01). Dead space fraction calculation using the estimate from physiological variables [V Estimated methods for dead space calculation and the ventilatory ratio during the early course of ARDS are associated with mortality at day 30 and add statistically significant but limited improvement in the predictive accuracy to indices of oxygenation and respiratory system mechanics at the second day of mechanical ventilation.
Sections du résumé
BACKGROUND
BACKGROUND
Indirect indices for measuring impaired ventilation, such as the estimated dead space fraction and the ventilatory ratio, have been shown to be independently associated with an increased risk of mortality. This study aimed to compare various methods for dead space estimation and the ventilatory ratio in patients with acute respiratory distress syndrome (ARDS) and to determine their independent values for predicting death at day 30. The present study is a post hoc analysis of a prospective observational cohort study of ICUs of two tertiary care hospitals in the Netherlands.
RESULTS
RESULTS
Individual patient data from 940 ARDS patients were analyzed. Estimated dead space fraction and the ventilatory ratio at days 1 and 2 were significantly higher among non-survivors (p < 0.01). Dead space fraction calculation using the estimate from physiological variables [V
CONCLUSIONS
CONCLUSIONS
Estimated methods for dead space calculation and the ventilatory ratio during the early course of ARDS are associated with mortality at day 30 and add statistically significant but limited improvement in the predictive accuracy to indices of oxygenation and respiratory system mechanics at the second day of mechanical ventilation.
Identifiants
pubmed: 31754866
doi: 10.1186/s13613-019-0601-0
pii: 10.1186/s13613-019-0601-0
pmc: PMC6872683
doi:
Types de publication
Journal Article
Langues
eng
Pagination
128Investigateurs
Friso M de Beer
(FM)
Lieuwe D Bos
(LD)
Gerie J Glas
(GJ)
Janneke Horn
(J)
Arie J Hoogendijk
(AJ)
Roosmarijn T van Hooijdonk
(RT)
Mischa A Huson
(MA)
Tom van der Poll
(T)
Brendon Scicluna
(B)
Laura R Schouten
(LR)
Marcus J Schultz
(MJ)
Marleen Straat
(M)
Lonneke A van Vught
(LA)
Luuk Wieske
(L)
Maryse A Wiewel
(MA)
Esther Witteveen
(E)
Marc J Bonten
(MJ)
Olaf L Cremer
(OL)
Jos F Frencken
(JF)
Kirsten van de Groep
(K)
Peter M Klein Klouwenberg
(PM)
Maria E Koster-Brouwer
(ME)
David S Ong
(DS)
Meri R Varkila
(MR)
Diana M Verboom
(DM)
Références
Am J Pathol. 1983 Jul;112(1):112-26
pubmed: 6859225
N Engl J Med. 2000 May 4;342(18):1301-8
pubmed: 10793162
JPEN J Parenter Enteral Nutr. 2011 Mar;35(2):264-9
pubmed: 21378256
J Thorac Imaging. 1986 Jul;1(3):31-8
pubmed: 3298679
Intensive Care Med. 1998 Oct;24(10):1018-28
pubmed: 9840234
Crit Care Med. 2013 Oct;41(10):2373-8
pubmed: 23921277
Thorax. 2008 Nov;63(11):994-8
pubmed: 18566110
Heart. 2012 May;98(9):683-90
pubmed: 22397945
Respir Care. 2017 Oct;62(10):1241-1248
pubmed: 28611227
Am J Clin Nutr. 1990 Feb;51(2):241-7
pubmed: 2305711
JAMA. 2016 Feb 23;315(8):788-800
pubmed: 26903337
N Engl J Med. 2002 Apr 25;346(17):1281-6
pubmed: 11973365
Crit Care Med. 1994 May;22(5):796-802
pubmed: 8181288
Am Rev Respir Dis. 1988 Sep;138(3):720-3
pubmed: 3202424
Intensive Care Med. 2018 May;44(5):564-577
pubmed: 29632996
Respir Care. 2004 Sep;49(9):1008-14
pubmed: 15329171
Heart. 2012 May;98(9):691-8
pubmed: 22397946
JPEN J Parenter Enteral Nutr. 2009 Jan-Feb;33(1):27-36
pubmed: 19011147
J Physiol. 1949 Aug;109(1-2):1-9
pubmed: 15394301
Am J Respir Crit Care Med. 2019 Feb 1;199(3):333-341
pubmed: 30211618
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452
Proc Natl Acad Sci U S A. 1918 Dec;4(12):370-3
pubmed: 16576330
Br J Anaesth. 2009 May;102(5):692-7
pubmed: 19346233
Anesth Analg. 1980 May;59(5):341-9
pubmed: 7189380
Crit Care. 2010;14(4):R141
pubmed: 20670411
Am J Respir Crit Care Med. 2007 Oct 15;176(8):795-804
pubmed: 17585106
Can Anaesth Soc J. 1981 Jul;28(4):370-2
pubmed: 6790141
Am J Respir Crit Care Med. 2002 Feb 15;165(4):443-8
pubmed: 11850334
Crit Care Med. 2015 May;43(5):1026-35
pubmed: 25738857
Chest. 1984 Dec;86(6):815-8
pubmed: 6437750
Intensive Care Med. 2011 Dec;37(12):1932-41
pubmed: 21997128
Am J Respir Crit Care Med. 2013 May 15;187(10):1150-3
pubmed: 23675728