Trial reportRespiratory care2014
The association between physiologic dead-space fraction and mortality in subjects with ARDS enrolled in a prospective multi-center clinical trial.
Trial report in Respiratory care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 97 citations in OpenAlex.
- The prognostic value of early measures of the ventilatory ratio in the ARDS ROSE trial.Critical care (London, England) · 2022Trial
- Thrombomodulin is associated with increased mortality and organ failure in mechanically ventilated children with acute respiratory failure: biomarker analysis from a multicenter randomized controlled trial.Critical care (London, England) · 2021Trial
- Nasal high flow reduces dead space.Journal of applied physiology (Bethesda, Md. : 1985) · 2017Trial
- Influence of airway pressure release ventilation on pulmonary gas exchange using ventilatory ratio.Frontiers in medicine · 2026Article
- Direct, minimally intrusive quantification of rebreathing in the circle breathing system during spontaneous breathing: a proof-of-concept feasibility study.Frontiers in medicine · 2026Article
- Predictors of VV-ECMO weaning safety: longitudinal ventilatory ratio assessment during sweep gas off trials, a retrospective cohort study.BMC anesthesiology · 2025Article
- Article
- Testing pulmonary physiology in ventilated non-human primates.Journal of medical primatology · 2024Article
- Physiologic Markers of Disease Severity in ARDS.Respiratory care · 2023Review
- Personalized Respiratory Support in ARDS: A Physiology-to-Bedside Review.Journal of clinical medicine · 2023Review
- Physiologic dead space is independently associated with mortality and discharge of mechanically ventilated patients with COVID-19 ARDS: a retrospective study.Scientific reports · 2023Article
- The end-tidal alveolar dead space fraction for risk stratification during the first week of invasive mechanical ventilation: an observational cohort study.Critical care (London, England) · 2023Observational
- Pathophysiology and Clinical Meaning of Ventilation-Perfusion Mismatch in the Acute Respiratory Distress Syndrome.Biology · 2022Review
- Increased respiratory dead space could associate with coagulation activation and poor outcomes in COVID-19 ARDS.Journal of critical care · 2022Article
- Ventilatory Ratio Is a Valuable Prognostic Indicator in an Observational Cohort of Patients With ARDS.Respiratory care · 2022Observational
- Dead space estimates may not be independently associated with 28-day mortality in COVID-19 ARDS.Critical care (London, England) · 2021Observational
- Comparison of the effects of 2 ventilatory strategies using tidal volumes of 6 and 8 ml/kg on pulmonary shunt and alveolar dead space volume in upper abdominal cancers surgery.Medical journal of the Islamic Republic of Iran · 2021Article
- Physiological mechanism and spatial distribution of increased alveolar dead-space in early ARDS: An experimental study.Acta anaesthesiologica Scandinavica · 2021Article
- Monitoring Expired COFrontiers in physiology · 2021Review
- Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study.Annals of intensive care · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWe tested the association between pulmonary dead-space fraction (ratio of dead space to tidal volume [V(D)/V(T)]) and mortality in subjects with ARDS (Berlin definition, P(aO2)/F(IO2) ≤ 300 mm Hg; PEEP ≥ 5 cm H2O) enrolled into a clinical trial incorporating lung-protective ventilation.
methodsWe conducted a prospective, multi-center study at medical-surgical ICUs in the United States. A total of 126 ALI subjects with acute lung injury were enrolled into a phase 3 randomized, placebo-controlled study of aerosolized albuterol. V(D)/V(T) and pulmonary mechanics were measured within 4 h of enrollment and repeated daily on study days 1 and 2 in subjects requiring arterial blood gases for clinical management.
resultsAt baseline, non-survivors had a trend toward higher V(D)/V(T) compared with survivors (0.62 ± 0.11 vs 0.56 ± 0.11, respectively, P = .08). Differences in V(D)/V(T) between non-survivors and survivors became significant on study days 1 (0.64 ± 0.12 vs 0.55 ± 0.11, respectively, P = .01) and 2 (0.67 ± 0.12 vs 0.56 ± 0.11, respectively, P = .004). Likewise, the association between VD/VT and mortality was significant on study day 1 (odds ratio per 0.10 change in V(D)/V(T) [95% CI]: 6.84 [1.62-28.84] P = .01; and study day 2: 4.90 [1.28-18.73] P = .02) after adjusting for V(D)/V(T), P(aO2)/F(IO2), oxygenation index, vasopressor use, and the primary risk for ARDS. Using a Cox proportional hazard model, V(D)/V(T) was associated with a trend toward higher mortality (HR = 4.37 [CI 0.99-19.32], P = .052) that became significant when the analysis was adjusted for daily oxygenation index (HR = 1.74 [95% CI 1.12-3.35] P = .04).
conclusionsMarkedly elevated V(D)/V(T) (≥ 0.60) in early ARDS is associated with higher mortality. Measuring V(D)/V(T) may be useful in identifying ARDS patients at increased risk of death who are enrolled into a therapeutic trial.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.