ArticleCritical care (London, England)2010
Bedside quantification of dead-space fraction using routine clinical data in patients with acute lung injury: secondary analysis of two prospective trials.
Article in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 29 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed.
- Efficacy of Noninvasive Ventilation With Expiratory Washout in Stable COPD Patients.Respiratory care · 2025Trial
- The association between physiologic dead-space fraction and mortality in subjects with ARDS enrolled in a prospective multi-center clinical trial.Respiratory care · 2014Trial
- Time-varying intensity of ventilatory inefficiency and mortality in patients with acute respiratory distress syndrome.Annals of intensive care · 2025Article
- Factors associated with decreased compliance after on-site extracorporeal membrane oxygenation cannulation for acute respiratory distress syndrome: A retrospective, observational cohort study.Journal of intensive medicine · 2024Article
- Prognostic value of time-varying dead space estimates in mechanically ventilated patients with acute respiratory distress syndrome.Journal of intensive medicine · 2024Article
- Individualized estimation of arterial carbon dioxide partial pressure using machine learning in children receiving mechanical ventilation.BMC pediatrics · 2024Observational
- Physiologic dead space is independently associated with mortality and discharge of mechanically ventilated patients with COVID-19 ARDS: a retrospective study.Scientific reports · 2023Article
- Dead space ventilation-related indices: bedside tools to evaluate the ventilation and perfusion relationship in patients with acute respiratory distress syndrome.Critical care (London, England) · 2023Review
- Ventilatory ratio as a predictor for extubation failure in critical ill patients based on MIMIC-IV database (from 2008 to 2019).Frontiers in physiology · 2023Article
- Pathophysiology and Clinical Meaning of Ventilation-Perfusion Mismatch in the Acute Respiratory Distress Syndrome.Biology · 2022Review
- Dead space estimates may not be independently associated with 28-day mortality in COVID-19 ARDS.Critical care (London, England) · 2021Observational
- Functional NMDA receptors are expressed by human pulmonary artery smooth muscle cells.Scientific reports · 2021Article
- Estimated dead space fraction and the ventilatory ratio are associated with mortality in early ARDS.Annals of intensive care · 2019Article
- Differences between Patients in Whom Physicians Agree and Disagree about the Diagnosis of Acute Respiratory Distress Syndrome.Annals of the American Thoracic Society · 2019Article
- Evaluating Delivery of Low Tidal Volume Ventilation in Six ICUs Using Electronic Health Record Data.Critical care medicine · 2019Observational
- Phosgene-induced acute lung injury (ALI): differences from chlorine-induced ALI and attempts to translate toxicology to clinical medicine.Clinical and translational medicine · 2017Review
- Dead space in acute respiratory distress syndrome: more than a feeling!Critical care (London, England) · 2016Article
- Comparison of the pulmonary dead-space fraction derived from ventilator volumetric capnography and a validated equation in the survival prediction of patients with acute respiratory distress syndrome.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2016Article
- Estimating dead-space fraction for secondary analyses of acute respiratory distress syndrome clinical trials.Critical care medicine · 2015Article
- What is the clinical significance of pulmonary hypertension in acute respiratory distress syndrome? A review.Minerva anestesiologica · 2014Review
Corrections and comments
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- Erratum issued
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDead-space fraction (Vd/Vt) has been shown to be a powerful predictor of mortality in acute lung injury (ALI) patients. The measurement of Vd/Vt is based on the analysis of expired CO2 which is not a part of standard practice thus limiting widespread clinical application of this method. The objective of this study was to determine prognostic value of Vd/Vt estimated from routinely collected pulmonary variables.
methodsSecondary analysis of the original data from two prospective studies of ALI patients. Estimated Vd/Vt was calculated using the rearranged alveolar gas equation: Vd/Vt=1-[(0.86×VCO2est)/(VE×PaCO2)] where VCO2est is the estimated CO2 production calculated from the Harris Benedict equation, minute ventilation (VE) is obtained from the ventilator rate and expired tidal volume and PaCO2 from arterial gas analysis. Logistic regression models were created to determine the prognostic value of estimated Vd/Vt.
resultsOne hundred and nine patients in Mayo Clinic validation cohort and 1896 patients in ARDS-net cohort demonstrated an increase in percent mortality for every 10% increase in Vd/Vt in a dose response fashion. After adjustment for non-pulmonary and pulmonary prognostic variables, both day 1 (adjusted odds ratio-OR = 1.07, 95%CI 1.03 to 1.13) and day 3 (OR = 1.12, 95% CI 1.06 to 1.18) estimated dead-space fraction predicted hospital mortality.
conclusionsElevated estimated Vd/Vt predicts mortality in ALI patients in a dose response manner. A modified alveolar gas equation may be of clinical value for a rapid bedside estimation of Vd/Vt, utilizing routinely collected clinical data.
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