About: PaCO(2 )and alveolar dead space are more relevant than PaO(2)/FiO(2 )ratio in monitoring the respiratory response to prone position in ARDS patients: a physiological study

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About: PaCO(2 )and alveolar dead space are more relevant than PaO(2)/FiO(2 )ratio in monitoring the respiratory response to prone position in ARDS patients: a physiological study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	PaCO(2 )and alveolar dead space are more relevant than PaO(2)/FiO(2 )ratio in monitoring the respiratory response to prone position in ARDS patients: a physiological study
Creator	Vieillard-Baron, Antoine Repesse, Xavier Bodson, Laurent Bouferrache, Koceïla Castro, Samuel Charron, Cyril Jardin, François Page, Bernard
Source	PMC
abstract	INTRODUCTION: Our aims in this study were to report changes in the ratio of alveolar dead space to tidal volume (VD(alv)/V(T)) in the prone position (PP) and to test whether changes in partial pressure of arterial CO(2 )(PaCO(2)) may be more relevant than changes in the ratio of partial pressure of arterial O(2 )to fraction of inspired O(2 )(PaO(2)/FiO(2)) in defining the respiratory response to PP. We also aimed to validate a recently proposed method of estimation of the physiological dead space (VD(physiol)/V(T)) without measurement of expired CO(2). METHODS: Thirteen patients with a PaO(2)/FiO(2 )ratio < 100 mmHg were included in the study. Plateau pressure (Pplat), positive end-expiratory pressure (PEEP), blood gas analysis and expiratory CO(2 )were recorded with patients in the supine position and after 3, 6, 9, 12 and 15 hours in the PP. Responders to PP were defined after 15 hours of PP either by an increase in PaO(2)/FiO(2 )ratio > 20 mmHg or by a decrease in PaCO(2 )> 2 mmHg. Estimated and measured VD(physiol)/V(T )ratios were compared. RESULTS: PP induced a decrease in Pplat, PaCO(2 )and VD(alv)/V(T )ratio and increases in PaO(2)/FiO(2 )ratios and compliance of the respiratory system (Crs). Maximal changes were observed after six to nine hours. Changes in VD(alv)/V(T )were correlated with changes in Crs, but not with changes in PaO(2)/FiO(2 )ratios. When the response was defined by PaO(2)/FiO(2 )ratio, no significant differences in Pplat, PaCO(2 )or VD(alv)/V(T )alterations between responders (n = 7) and nonresponders (n = 6) were observed. When the response was defined by PaCO(2), four patients were differently classified, and responders (n = 7) had a greater decrease in VD(alv)/V(T )ratio and in Pplat and a greater increase in PaO(2)/FiO(2 )ratio and in Crs than nonresponders (n = 6). Estimated VD(physiol)/V(T )ratios significantly underestimated measured VD(physiol)/V(T )ratios (concordance correlation coefficient 0.19 (interquartile ranges 0.091 to 0.28)), whereas changes during PP were more reliable (concordance correlation coefficient 0.51 (0.32 to 0.66)). CONCLUSIONS: PP induced a decrease in VD(alv)/V(T )ratio and an improvement in respiratory mechanics. The respiratory response to PP appeared more relevant when PaCO(2 )rather than the PaO(2)/FiO(2 )ratio was used. Estimated VD(physiol)/V(T )ratios systematically underestimated measured VD(physiol)/V(T )ratios.
has issue date	2011-07-25(xsd:dateTime)
bibo:doi	10.1186/cc10324
bibo:pmid	21791044
has license	cc-by
sha1sum (hex)	06cfa5d8ed55752e73d2cc570c6da1770e2cb2eb
schema:url	https://doi.org/10.1186/cc10324
resource representing a document's title	PaCO(2 )and alveolar dead space are more relevant than PaO(2)/FiO(2 )ratio in monitoring the respiratory response to prone position in ARDS patients: a physiological study
has PubMed Central identifier	PMC3387618
has PubMed identifier	21791044
schema:publication	Crit Care
resource representing a document's body	covid:06cfa5d8ed55752e73d2cc570c6da1770e2cb2eb#body_text
is schema:about of	named entity 'patients' named entity 'response' named entity 'arterial' named entity 'ratio' named entity 'measured' named entity 'ratios' named entity 'When' named entity 'partial pressure' named entity 'respiratory system' named entity 'estimation' named entity 'measurement' named entity 'supine position' named entity 'defined' named entity 'ratio' named entity 'ratio' named entity 'arterial' named entity 'reliable' named entity 'ratio' named entity 'greater' named entity 'supine position' named entity 'concordance correlation coefficient' named entity 'alveolar' named entity 'prone position' named entity 'physiological' named entity 'alveolar' named entity 'ARDS' named entity 'prone position' named entity 'defined' named entity 'pathophysiological' named entity 'chest wall' named entity 'influenza' named entity 'blood gas analysis' named entity 'mmHg' named entity 'lung capacity' named entity 'informed consent' named entity 'mmHg' named entity 'mmHg' named entity 'alveolar' named entity 'functional residual capacity' named entity 'study population' named entity '95% CI' named entity 'ARDS' named entity 'mmHg' named entity 'heart rate' named entity 'humidifier' named entity 'Cary, NC' named entity 'interquartile range' named entity 'ARDS' named entity 'prone position' named entity 'mmHg' named entity 'physiological' named entity 'ventilator' named entity 'dead space' named entity 'Physiology' named entity 'mmHg' named entity 'proximal' named entity 'acute respiratory distress syndrome' named entity 'Ventilator settings' named entity 'Harris-Benedict equation' named entity 'body weight' named entity 'PEEP' named entity 'arterial catheter' named entity 'Acute Respiratory Distress Syndrome' named entity '18 hours' named entity 'infusion' named entity 'hydrostatic gradient' named entity '95% confidence interval' named entity 'endotracheal tube' named entity 'chronic obstructive pulmonary disease' named entity 'PEEP' named entity 'controlled trials' named entity 'lung' named entity 'dead space' named entity 'minute ventilation'

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