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Research ArticleOriginal Research

Prognostic Value of the Pulmonary Dead-Space Fraction During the Early and Intermediate Phases of Acute Respiratory Distress Syndrome

Joan M Raurich, Margalida Vilar, Asunción Colomar, Jordi Ibáñez, Ignacio Ayestarán, Jon Pérez-Bárcena and Juan A Llompart-Pou
Respiratory Care March 2010, 55 (3) 282-287;
Joan M Raurich
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Illes Balears, Spain.
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  • For correspondence: [email protected]
Margalida Vilar
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Illes Balears, Spain.
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Asunción Colomar
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Illes Balears, Spain.
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Jordi Ibáñez
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Illes Balears, Spain.
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Ignacio Ayestarán
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Illes Balears, Spain.
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Jon Pérez-Bárcena
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Illes Balears, Spain.
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Juan A Llompart-Pou
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Illes Balears, Spain.
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Abstract

BACKGROUND: Little is known about the alveolar dead-space fraction after the first week of acute respiratory distress syndrome (ARDS). We measured the dead-space fraction in the early phase (first week) and the intermediate phase (second week) of ARDS, and evaluated the association of dead-space fraction with mortality.

METHODS: We prospectively measured dead-space fraction and other variables in 80 intubated patients during the early phase of ARDS and in 49 patients during the intermediate phase. We used multiple logistic regression analysis to evaluate data. The primary outcome was in-hospital mortality.

RESULTS: In the early and intermediate phases the dead-space fraction was higher in patients who died than among those who survived (dead-space fraction 0.64 ± 0.09 vs 0.53 ± 0.11, P < .001, and 0.62 ± 0.09 vs 0.50 ± 0.10, P < .001, respectively). In both the early and intermediate phases the dead-space fraction was independently associated with a greater risk of death. For every dead-space-fraction increase of 0.05 the odds of death increased by 59% in the early phase (odds ratio 1.59, 95% confidence interval 1.18–2.16, P = .003) and by 186% in the intermediate phase (odds ratio 2.87, 95% confidence interval 1.36–6.04, P = .005). Age and Sequential Organ Failure Assessment score were also independently associated with a greater risk of death in both phases.

CONCLUSIONS: Increased alveolar dead-space fraction in the early and intermediate phases of ARDS is associated with a greater risk of death.

  • acute respiratory distress syndrome
  • ARDS
  • respiratory dead space
  • mechanical ventilation
  • survival

Footnotes

  • Correspondence: Joan M Raurich MD PhD, Intensive Care Unit, Hospital Universitario Son Dureta, Calle Andrea Doria 55, 07014, Palma de Mallorca, Illes Balears, Spain. E-mail: joan.raurich{at}ssib.es.
  • The authors have disclosed no conflicts of interest.

  • See the Related Editorial on Page 350

  • Copyright © 2010 by Daedalus Enterprises Inc.
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Respiratory Care: 55 (3)
Respiratory Care
Vol. 55, Issue 3
1 Mar 2010
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Prognostic Value of the Pulmonary Dead-Space Fraction During the Early and Intermediate Phases of Acute Respiratory Distress Syndrome
Joan M Raurich, Margalida Vilar, Asunción Colomar, Jordi Ibáñez, Ignacio Ayestarán, Jon Pérez-Bárcena, Juan A Llompart-Pou
Respiratory Care Mar 2010, 55 (3) 282-287;

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Prognostic Value of the Pulmonary Dead-Space Fraction During the Early and Intermediate Phases of Acute Respiratory Distress Syndrome
Joan M Raurich, Margalida Vilar, Asunción Colomar, Jordi Ibáñez, Ignacio Ayestarán, Jon Pérez-Bárcena, Juan A Llompart-Pou
Respiratory Care Mar 2010, 55 (3) 282-287;
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Keywords

  • Acute respiratory distress syndrome
  • ARDS
  • respiratory dead space
  • mechanical ventilation
  • survival

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