ArticleCritical care medicine2015
Estimating dead-space fraction for secondary analyses of acute respiratory distress syndrome clinical trials.
Article in Critical care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The trial behind it
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
27 citing papers in PubMed.
- Physiological effects and safety of bed verticalization in patients with acute respiratory distress syndrome.Critical care (London, England) · 2024Trial
- Dead space in critical care: a practical approach with clinical scenarios.Journal of anesthesia, analgesia and critical care · 2026Review
- Preparing for future pandemics: Automated intensive care electronic health record data extraction to accelerate clinical insights.Journal of intensive medicine · 2025Article
- Correlation of sonographic and radiographic scores of lung edema and metrics of shunt, dead space, and respiratory mechanics in invasively ventilated patients.Critical care science · 2025Observational
- Prognostic value of time-varying dead space estimates in mechanically ventilated patients with acute respiratory distress syndrome.Journal of intensive medicine · 2024Article
- Association between ventilatory ratio and mortality in patients with acute respiratory distress syndrome and COVID 19: A multicenter, retrospective cohort study.BMC pulmonary medicine · 2023Observational
- Gas volume corrections in intensive care unit: needed or pointless?Journal of applied physiology (Bethesda, Md. : 1985) · 2023Article
- 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
- Pathophysiology and Clinical Meaning of Ventilation-Perfusion Mismatch in the Acute Respiratory Distress Syndrome.Biology · 2022Review
- Physiological response to prone positioning in intubated adults with COVID-19 acute respiratory distress syndrome: a retrospective study.Respiratory research · 2022Article
- Cardiovascular subphenotypes in patients with COVID-19 pneumonitis whose lungs are mechanically ventilated: a single-centre retrospective observational study.Anaesthesia · 2022Observational
- The Association Between Alveolar Dead Space Fraction and Mortality in Pediatric Acute Respiratory Distress Syndrome: A Prospective Cohort Study.Frontiers in pediatrics · 2022Article
- Respiratory Physiology of Prone Positioning With and Without Inhaled Nitric Oxide Across the Coronavirus Disease 2019 Acute Respiratory Distress Syndrome Severity Spectrum.Critical care explorations · 2021Article
- Dead space estimates may not be independently associated with 28-day mortality in COVID-19 ARDS.Critical care (London, England) · 2021Observational
- Timing of Intubation in Coronavirus Disease 2019: A Study of Ventilator Mechanics, Imaging, Findings, and Outcomes.Critical care explorations · 2021Article
- Early experience with critically ill patients with COVID-19 in Montreal.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Article
- Pathophysiology of COVID-19-associated acute respiratory distress syndrome.The Lancet. Respiratory medicine · 2021Article
- Resting Dead Space Fraction as Related to Clinical Characteristics, Lung Function, and Gas Exchange in Male Patients with Chronic Obstructive Pulmonary Disease.International journal of general medicine · 2021Article
- Phenotypes and personalized medicine in the acute respiratory distress syndrome.Intensive care medicine · 2020Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectivesPulmonary dead-space fraction is one of few lung-specific independent predictors of mortality from acute respiratory distress syndrome. However, it is not measured routinely in clinical trials and thus altogether ignored in secondary analyses that shape future research directions and clinical practice. This study sought to validate an estimate of dead-space fraction for use in secondary analyses of clinical trials.
designAnalysis of patient-level data pooled from acute respiratory distress syndrome clinical trials. Four approaches to estimate dead-space fraction were evaluated: three required estimating metabolic rate; one estimated dead-space fraction directly.
settingU.S. academic teaching hospitals. PATIENTS: Data from 210 patients across three clinical trials were used to compare performance of estimating equations with measured dead-space fraction. A second cohort of 3,135 patients from six clinical trials without measured dead-space fraction was used to confirm whether estimates independently predicted mortality.
interventionsNone. MEASUREMENTS AND MAIN
resultsDead-space fraction estimated using the unadjusted Harris-Benedict equation for energy expenditure was unbiased (mean ± SD Harris-Benedict, 0.59 ± 0.13; measured, 0.60 ± 0.12). This estimate predicted measured dead-space fraction to within ±0.10 in 70% of patients and ±0.20 in 95% of patients. Measured dead-space fraction independently predicted mortality (odds ratio, 1.36 per 0.05 increase in dead-space fraction; 95% CI, 1.10-1.68; p < 0.01). The Harris-Benedict estimate closely approximated this association with mortality in the same cohort (odds ratio, 1.55; 95% CI, 1.21-1.98; p < 0.01) and remained independently predictive of death in the larger Acute Respiratory Distress Syndrome Network cohort. Other estimates predicted measured dead-space fraction or its association with mortality less well.
conclusionsDead-space fraction should be measured in future acute respiratory distress syndrome clinical trials to facilitate incorporation into secondary analyses. For analyses where dead-space fraction was not measured, the Harris-Benedict estimate can be used to estimate dead-space fraction and adjust for its association with mortality.
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