Utility of the dead space fraction (Vd/Vt) as a predictor of extubation success

González-Castro, A.; Suárez-Lopez, V.; Gómez-Marcos, V.; González-Fernández, Camilo; Iglesias-Posadilla, D.; Burón-Mediavilla, J.; Rodríguez-Borregán, J.C.; Miñambres, Eduardo; Llorca, Javier

doi:10.1016/j.medine.2012.01.002

Cited by 16 publications

(12 citation statements)

References 31 publications

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“…Dead space fraction has been shown to be a powerful predictor of extubation success in the adult population. 11 But calculation of dead space fraction, (P aCO 2 Ϫ P ETCO 2 )/P aCO 2 , requires invasive arterial blood sampling and measurement of mean exhaled CO 2 . These requirements limit its 12 there is very limited literature available on its utility to predict extubation outcome in adults.…”

Section: Discussionmentioning

confidence: 99%

Role of Integrated Pulmonary Index in Identifying Extubation Failure

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Role of Integrated Pulmonary Index in Identifying Extubation Failure

et al. 2017

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“…Esses resultados são consistentes com os achados de três estudos prévios, dois em adultos 13,14 e um em crianças 9 , todos com valor limite semelhante (entre 0,50 e 0,60).…”

Section: Discussionunclassified

Predictive value of the physiological deadspace/tidal volume ratio in the weaning process of mechanical ventilation in children

Riou¹,

Chaari²,

Leteurtre³

et al. 2012

J Pediatr (Rio J)

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Objective: To evaluate the physiological deadspace/tidal volume ratio (V D /V T ) as a predictor of extubation failure in 42 ventilated children (median age: 4.75 years).Method: Extubation readiness was determined using the criteria proposed by the 6 th International Consensus Conference on Intensive Care Medicine adapted to children.Results: Non-invasive ventilation (NIV) was used in four patients who developed respiratory failure after extubation; none was reintubated. Children who needed NIV to avoid reintubation had a significantly higher V D /V T ratio than those who were extubated without NIV (p < 0.001). The cut-off value of V D /V T ratio was 0.55 and the area under the receiver operating characteristic curve was 0.86. Conclusion:Our findings confirm the good predictive value of weaning success/failure of the V D /V T ratio and suggest its role for predicting the need for NIV after extubation. J Pediatr (Rio J). 2012;88(3):217-21:Weaning from mechanical ventilation, capnography, VD/VT ratio, children. ResumoObjetivo: Avaliar a razão entre espaço morto e volume corrente fisiológicos (V D /V T ) como preditor do fracasso na extubação em 42 crianças ventiladas (idade média: 4,75 anos).Método: Prontidão para extubação foi determinada usando os critérios propostos pela 6 a Conferência Internacional de Consenso em Medicina Intensiva adaptados a crianças.

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“…V D /V T assessments may also be used to predict extubation success in pediatric 136 and adult patients. 137,138 Values for V D /V T Յ 0.50 and Ն 0.65 in infants and children were found to predict extubation success or failure 136 (Fig. 12), whereas in adult patients, the cutoff value for V D /V T ϭ 0.58 offered the best sensitivity and specificity for predicting extubation failure.…”

Section: Predicting Successful Liberation From Mechanical Ventilationmentioning

confidence: 98%

“…12), whereas in adult patients, the cutoff value for V D /V T ϭ 0.58 offered the best sensitivity and specificity for predicting extubation failure. 137 It has also been suggested that elevated V D /V T may be useful for predicting the need for noninvasive ventilation after extubation 138 and therefore the potential for averting the need for re-intubation.…”

Section: Predicting Successful Liberation From Mechanical Ventilationmentioning

confidence: 99%

“…It has also been suggested that simultaneous assessment of Enghoff and Bohr dead space using volumetric capnog-raphy may be useful in regard to recognizing the effects of shunt and V /Q inequality versus true dead space or wasted ventilation in critically ill patients with elevated V D /V T . 149 Since many studies that identified V D /V T as a predictor of outcome, disease diagnosis, and disease severity used the Enghoff equation, [125][126][127][128][129][130][131][136][137][138][141][142][143][144][145][146][147][148] the conclusions of these studies may need to be reexamined using this new approach.…”

Section: Bohr Versus Enghoff Approach To Physiologic Dead Space Measumentioning

confidence: 99%

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Monitoring Exhaled Carbon Dioxide

Siobal

2016

Respir Care

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In the past few decades, assessment of exhaled CO2 in both intubated and non-intubated patients has evolved into an essential component in many aspects of patient monitoring. Besides the basic assessment of ventilation, exhaled CO2 monitoring can provide valuable patient safety information and critical physiologic data in regard to the ventilation and perfusion matching in the lungs, cardiac output, and metabolic rate. Despite these important clinical monitoring benefits and widespread availability, exhaled CO2 monitoring is often underutilized. The purpose of this paper is to review the importance and present the extensive body of knowledge to support the use of exhaled CO2 monitoring in various areas of clinical practice. Advanced application concepts and the future development of exhaled CO2 monitoring will also be discussed.

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Utility of the dead space fraction (Vd/Vt) as a predictor of extubation success

Cited by 16 publications

References 31 publications

Role of Integrated Pulmonary Index in Identifying Extubation Failure

Role of Integrated Pulmonary Index in Identifying Extubation Failure

Predictive value of the physiological deadspace/tidal volume ratio in the weaning process of mechanical ventilation in children

Monitoring Exhaled Carbon Dioxide

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