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Research ArticleOriginal Contributions

Accuracy of Physiologic Dead Space Measurements in Patients With Acute Respiratory Distress Syndrome Using Volumetric Capnography: Comparison With the Metabolic Monitor Method

Richard H Kallet, Brian M Daniel, Oscar Garcia and Michael A Matthay
Respiratory Care April 2005, 50 (4) 462-467;
Richard H Kallet
Cardiovascular Research Institute, University of California, San Francisco.
Respiratory Care Services, Department of Anesthesia, University of California, San Francisco at San Francisco General Hospital
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  • For correspondence: [email protected]
Brian M Daniel
Cardiovascular Research Institute, University of California, San Francisco.
Respiratory Care Services, Department of Anesthesia, University of California, San Francisco at Moffitt-Long Hospital
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Oscar Garcia
Cardiovascular Research Institute, University of California, San Francisco.
Respiratory Care Services, Department of Anesthesia, University of California, San Francisco at Moffitt-Long Hospital
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Michael A Matthay
Cardiovascular Research Institute, University of California, San Francisco.
Departments of Medicine and Anesthesia, University of California, San Francisco, San Francisco, California.
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Abstract

BACKGROUND: Volumetric capnography is an alternative method of measuring expired carbon dioxide partial pressure (PeCO2) and physiologic dead-space-to-tidal-volume ratio (VD/VT) during mechanical ventilation. In this method, PeCO2 is measured at the Y-adapter of the ventilator circuit, thus eliminating the effects of compression volume contamination and the need to apply a correction factor. We investigated the accuracy of volumetric capnography in measuring VD/VT, compared to both uncorrected and corrected measurements, using a metabolic monitor in patients with acute respiratory distress syndrome (ARDS).

METHODS: There were 90 measurements of VD/VT made in 23 patients with ARDS. The PeCO2 was measured during a 5-min expired-gas collection period with a Delta-trac metabolic monitor, and was corrected for compression volume contamination using a standard formula. Simultaneous measurements of PeCO2 and VD/VT were obtained using volumetric capnography.

RESULTS: VD/VT measured by volumetric capnography was strongly correlated with both the uncorrected (r2 = 0.93, p < 0.0001) and corrected (r2 = 0.89, p < 0.0001) measurements of VD/VT made using the metabolic monitor technique. Measurements of VD/VT made with volumetric capnography had a bias of 0.02 and a precision of 0.05 when compared to the VD/VT corrected for estimated compression volume contamination.

CONCLUSION: Volumetric capnography measurements of VD/VT in mechanically-ventilated patients with ARDS are as accurate as those obtained by metabolic monitor technique.

  • acute respiratory distress syndrome
  • dead-space fraction
  • dead-space-to-tidal volume ratio
  • volumetric capnography
  • metabolic
  • monitor

Footnotes

  • Correspondence: Richard H Kallet MSc RRT FAARC, Respiratory Care Services, San Francisco General Hospital, NH: GA–2, 1001 Potrero Avenue, San Francisco CA 94110. E-mail: richkallet{at}earthlink.net.
  • Copyright © 2005 by Daedalus Enterprises Inc.
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Respiratory Care: 50 (4)
Respiratory Care
Vol. 50, Issue 4
1 Apr 2005
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Accuracy of Physiologic Dead Space Measurements in Patients With Acute Respiratory Distress Syndrome Using Volumetric Capnography: Comparison With the Metabolic Monitor Method
Richard H Kallet, Brian M Daniel, Oscar Garcia, Michael A Matthay
Respiratory Care Apr 2005, 50 (4) 462-467;

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Accuracy of Physiologic Dead Space Measurements in Patients With Acute Respiratory Distress Syndrome Using Volumetric Capnography: Comparison With the Metabolic Monitor Method
Richard H Kallet, Brian M Daniel, Oscar Garcia, Michael A Matthay
Respiratory Care Apr 2005, 50 (4) 462-467;
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Keywords

  • Acute respiratory distress syndrome
  • dead-space fraction
  • dead-space-to-tidal volume ratio
  • volumetric capnography
  • metabolic
  • monitor

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