title: Predictive value of the physiological deadspace/tidal volume ratio in the weaning process of mechanical ventilation in children.
abstract: OBJECTIVE
  To evaluate the physiological deadspace/tidal volume ratio (VD/VT) as a predictor of extubation failure in 42 ventilated children (median age: 4.75 years).
  
  
  METHODS
  Extubation readiness was determined using the criteria proposed by the 6th 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 VD/VT ratio than those who were extubated without NIV (p < 0.001). The cut-off value of VD/VT ratio was 0.55 and the area under the receiver operating characteristic curve was 0.86.
  
  
  CONCLUSIONS
  Our findings confirm the good predictive value of weaning success/failure of the VD/VT ratio and suggest its role for predicting the need for NIV after extubation.
authors.affiliation: University Hospital Jeanne de Flandre, Centre Hospitalier Régional Universitaire (CHRU), Lille, France.
authors.forename: Yvon
authors.initials: Y
authors.lastname: Riou
authors.forename: Wissem
authors.initials: W
authors.lastname: Chaari
authors.forename: Stéphane
authors.initials: S
authors.lastname: Leteurtre
authors.forename: Francis
authors.initials: F
authors.lastname: Leclerc
mesh_terms: D000293:Adolescent; D060666:Airway Extubation; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D063087:Noninvasive Ventilation; D011237:Predictive Value of Tests; D012372:ROC Curve; D012126:Respiratory Dead Space / Q000502:physiology; D012131:Respiratory Insufficiency / Q000628:therapy*; D013990:Tidal Volume / Q000502:physiology; D015300:Ventilator Weaning