Estimation of dead space fraction can be simplified in the acute respiratory distress syndrome.
Acute lung injury and acute respiratory distress syndrome are characterized by a non-cardiogenic pulmonary edema responsible for a significant impairment of gas exchange. The pulmonary dead space increase, which is due primarily to an alteration in pulmonary blood flow distribution, is largely responsible for carbon dioxide retention. Previous studies, computing the pulmonary dead space by measuring the expired carbon dioxide and the Enghoff equation, found that the dead space fraction was significantly higher in the non-survivors; it was even an independent risk of death. The computation of the dead space not by measuring the expired carbon dioxide but by applying a rearranged alveolar gas equation that takes into account only the weight, age, height, and temperature of the patient could lead to widespread clinical diffusion of this measurement at the bedside.
Chiumello
Davide
D
Dipartimento di Anestesia, Rianimazione e Terapia del dolore, Fondazione IRCCS, Cà Granda-Ospedale Maggiore Policlinico, Via F, Sforza 35, Milan, Italy. chiumello@libero.it
Gallazzi
Elisabetta
E
D000818:Animals; D006801:Humans; D011650:Pulmonary Alveoli / Q000502:physiology; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012126:Respiratory Dead Space / Q000502:physiology*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D012129:Respiratory Function Tests / Q000592:standards