Prognostic Value of the Pulmonary Dead-space Fraction in Patients of Acute Respiratory Distress Syndrome

Xu Mian; Yang De Xing; Yan Yue Xin; Liu Ya Ming; Zhou Feng Gao; Xu Cheng; Liu Rong

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Xu Mian , Yang De Xing , Yan Yue Xin , Liu Ya Ming , Zhou Feng Gao , Xu Cheng , Liu Rong . Prognostic Value of the Pulmonary Dead-space Fraction in Patients of Acute Respiratory Distress Syndrome[J]. Journal of Kunming Medical University, 2017, 38(06): 73-76.

Citation:

Xu Mian , Yang De Xing , Yan Yue Xin , Liu Ya Ming , Zhou Feng Gao , Xu Cheng , Liu Rong . Prognostic Value of the Pulmonary Dead-space Fraction in Patients of Acute Respiratory Distress Syndrome[J]. Journal of Kunming Medical University, 2017, 38(06): 73-76.

Citation:

Xu Mian , Yang De Xing , Yan Yue Xin , Liu Ya Ming , Zhou Feng Gao , Xu Cheng , Liu Rong . Prognostic Value of the Pulmonary Dead-space Fraction in Patients of Acute Respiratory Distress Syndrome[J]. Journal of Kunming Medical University, 2017, 38(06): 73-76.

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Prognostic Value of the Pulmonary Dead-space Fraction in Patients of Acute Respiratory Distress Syndrome

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基金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目 (2014FZ007);

Received Date: 2017-02-19

Abstract

Abstract

Objective To investigate the effect of pulmonary dead-space fraction on the prognosis of acute respiratory distress syndrome (ARDS) . Me thods 32 patients meeting ARDS Berlin definition, who were admitted to the EICU from January 2015 to August 2016, were analyzed with a prospective method. The VD/VT was measured by the single breath test of CO2. (day6 from day1) . Patients' general condition, vital signs, APACHEⅡ, LIPS, Pa O2/Fi O2, 28-day mortality were recorded.The patients were divided into a survival group and a death group according to their survival situation in 28 days. Re s ults Comparison of VD/VT between the death group and the survival group of ARDS patients at different time point: VD/VT was elevated in the two groups.VD/VT showed no statistical difference from the 1st day to the 3th day after admission, but higher in the death group from the 4th day to the 6th day after admission (P<0.01) .VD/VT was significantly higher in non survivors than in survivors from the 4th day of mechanical ventilation. ROC curve and 28-day survival curve showed that the area under ROC curve of VD/VT predicting prognosis of patients with ARDS was 0.910, higher than APACHEⅡand LIPS. When the optimal cut off value was 0.62, the sensitivity was 0.916, and specificity was 0.955. Conclus ion VD/VT is a risk factor of patients 28 day prognosis, VD/VT of the 4th day of ARDS is associated with greater risk of death.
- Dead space fraction,
- Acute respiratory distress syndrome,
- Mechanical ventilation,
- Prognosis

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References(15)

References

[1]	[1]TSUSHIMA K, KING LS, AGGARWAL N R, et al.Acute lung injury review[J].Intern Med, 2009, 48 (9) :621-630.
[2]	[3]COOKE C R, KAHN J M, CALDWELL E, et al.Predictors of hospital mortality in a population-based cohort of patients with acute lunginjury[J].Crit Care Med, 2008, 36 (5) :1412-1420.
[3]	[3]JEREMY R, BEITLER, TAYLOR THOMPSON, MICHAEL A, et a1.Estimating dead-space fraction for secondary analyses of ARDSclinical trials[J].Crit Care Med, 2015, 43 (5) :1026-1035.
[4]	[4] THE ARDS DEFINITION TASK FORCE, RANIERI VM, RUBENFELD G D, THOMPSON B T, et al.Acute repiratory distress syndrome Berlin Definition[J].JAMA, 2012, 307 (23) :2526-2533.
[5]	[5]FOWLER W S.Lung function studies:the respiratory dead space[J].Am J Physiol, 1948, 154 (154) :405-416.
[6]	[6] FERGUSON N D, FAN E, CAMPOROTA L, et al.The Berlin definition of ARDS:an expanded rationale, justification, and supplementary material[J].Intensive Care Med, 2012, 38 (10) :1573-1582.
[7]刘松桥, 陈菁, 郭凤梅, 等.死腔分数与早期急性呼吸窘迫综合征患者预后的关系[J].中华急诊医学杂志, 2012, 21 (6) :597-601.
[8]	[8] RANIERI V M, RUBENFELD G D, et al.ARDS Definition Task Force.Acute respiratory distress syndrome:the Berlin Definition[J]:JAMA, 2012, 307 (23) :2526-2533.
[9]	[9]FERGUSON N D, FAN E, CAMPOROTA L, et al.The Berlin definition of ARDS:an expanded rationale, justification, and supplementary material[J].Intensive Care Med, 2012, 38 (10) :1573-1582.
[10]	[10]SEELEY E, MCAULEY DF, EISNER M, et al.Predictors of mortality in acute lung injury during the era of lung protective ventilation[J].Thorax, 2008, 63 (11) :994-998.
[11]	[11]RICHARD H, KALLET, MS RRT FAARCA, et al, The association between physiologic dead space fraction and mortality in patients with the acute respiratory distress syndrome enrolled into a prospective multi-centered clinical trail[J].TRIALRespir Care, 2014, 59 (11) :1611-1618.
[12]	[12]YU-JIAO ZHANG, XIN-JING GAO, ZHI-BO, et al.Comparison of the pulmonary dead-space fraction derived from ventilator volumetric capnography and a validated equation in the survival prediction of patients with acute respiratory distress syndrome[J].Chinese Journal of Traumatology, 2016, 19 (3) :141-145.
[13]	[13]RAURIEH J M, VILAR M, COLORANT A, et al.Prognostic value of the pulmonary dead-space franfion during the early and intermediate phases of acute respiratory distress syndrome[J].Respir Care, 2010, 55 (3) :282-287.
[14]	[14]VENDER R L, BETANCOURT M F, LEHMAN E B, et al.Prediction equation to estimate dead space to tidal volume fraction correlates with mortality in critically ill patients[J].Crit Care, 2014, 29 (2) :e311-e313.
[15]	[15]NOAH MA, PEEK G J, FINNEY S J, et al.Referral to an extracorporeal membrane oxygenation center and mortality among patients with severe 2009 influenza A (HINI) [J].JAMA, 2011, 306 (15) :1659-1668.

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