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Monitoring Dead Space in Mechanically Ventilated Children: Volumetric Capnography Versus Time-Based Capnography.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Bhalla, Anoopindar K. Rubin, Sarah Newth, Christopher J. L. Ross, Patrick A. Morzov, Rica Soto-Campos, Gerardo Khemani, Robinder G. |
| Copyright Year | 2015 |
| Abstract | BACKGROUND Volumetric capnography dead-space measurements (physiologic dead-space-to-tidal-volume ratio [VD/VT] and alveolar VD/VT) are considered more accurate than the more readily available time-based capnography dead-space measurement (end-tidal alveolar dead-space fraction [AVDSF]). We sought to investigate the correlation between volumetric capnography and time-based capnography dead-space measurements. METHODS This was a single-center prospective cohort study of 65 mechanically ventilated children with arterial lines. Physiologic VD/VT, alveolar VD/VT, and AVDSF were calculated with each arterial blood gas using capnography data. RESULTS We analyzed 534 arterial blood gases from 65 children (median age 4.9 y, interquartile range 1.7-12.8). The correlation between physiologic VD/VT and AVDSF (r = 0.66, 95% CI 0.59-0.72) was weaker than the correlation between alveolar VD/VT and AVDSF (r = 0.8, 95% CI 0.76-0.85). The correlation between physiologic VD/VT and AVDSF was weaker in children with low PaO2 /FIO2 (< 200 mm Hg), low exhaled VT (< 100 mL), a pulmonary reason for mechanical ventilation, or large airway VD (> 3 mL/kg). All 3 dead-space measurements were highly correlated (r > 0.7) in children without hypoxemia (PaO2 /FIO2 > 300 mm Hg), mechanically ventilated for a neurologic or cardiac reason, or on significant inotropes or vasopressors. CONCLUSIONS In mechanically ventilated children without significant hypoxemia or with cardiac output-related dead-space changes, physiologic VD/VT was highly correlated with AVDSF and alveolar VD/VT. In children with significant hypoxemia, physiologic VD/VT was poorly correlated with AVDSF. Alveolar VD/VT and AVDSF correlated well in most tested circumstances. Therefore, AVDSF may be useful in most children for alveolar dead-space monitoring. |
| File Format | PDF HTM / HTML |
| DOI | 10.4187/respcare.03892 |
| PubMed reference number | 26199451 |
| Journal | Medline |
| Volume Number | 60 |
| Issue Number | 11 |
| Alternate Webpage(s) | http://rc.rcjournal.com/content/respcare/60/11/1548.full.pdf |
| Alternate Webpage(s) | http://rc.rcjournal.com/content/respcare/early/2015/07/21/respcare.03892.full.pdf |
| Journal | Respiratory care |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
