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Dead space analysis at different levels of positive end-expiratory pressure in acute respiratory distress syndrome patients
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
Inst Tecnol Buenos Aires ITBA, Buenos Aires, DF, Argentina.
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2018 (English)In: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 45, p. 231-238Article in journal (Refereed) Published
Abstract [en]

Purpose: To analyze the effects of positive end-expiratory pressure (PEEP) on Bohr's dead space (VDBohr/VT) in patients with acute respiratory distress syndrome (ARDS).

Material and methods: Fourteen ARDS patients under lung protective ventilation settingswere submitted to 4 different levels of PEEP (0, 6, 10, 16 cmH(2)O). Respiratory mechanics, hemodynamics and volumetric capnography were recorded at each protocol step.

Results: Two groups of patients responded differently to PEEP when comparing baseline with 16-PEEP: those in which driving pressure increased > 15% (Delta P.(15%), n = 7, p = .016) and those in which the change was <= 15% (Delta P-<= 15%, n = 7, p = .700). VDBohr/VT was higher in Delta P-<= 15% than in Delta P-<= 15% patients at baseline ventilation [0.58 (0.49-0.60) vs 0.46 (0.43-0.46) p = .018], at 0-PEEP [0.50 (0.47-0.54) vs 0.41 (0.40-0.43) p = .012], at 6-PEEP [0.55 (0.49-0.57) vs 0.44 (0.42-0.45) p = .008], at 10-PEEP [0.59 (0.51-0.59) vs 0.45 (0.44-0.46) p = .006] and at 16-PEEP [0.61 (0.56-0.65) vs 0.47 (0.45-0.48) p =. 001]. We found a good correlation between Delta P and VDBohr/VT only in the Delta P.(15%) group (r = 0.74, p < .001).

Conclusions: Increases in PEEP result in higher VDBohr/VT only when associated with an increase in driving pressure.

Place, publisher, year, edition, pages
W B SAUNDERS CO-ELSEVIER INC , 2018. Vol. 45, p. 231-238
Keywords [en]
ARDS, Volumetric capnography, PEEP, PACO(2), Dead space, Carbon dioxide
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:uu:diva-356615DOI: 10.1016/j.jcrc.2018.01.005ISI: 000432695500037PubMedID: 29754942OAI: oai:DiVA.org:uu-356615DiVA, id: diva2:1239923
Conference
National Meeting of Intensive Care Medicine, OCT, 2015, Mar del Plata, ARGENTINA
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-08-20Bibliographically approved

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Suarez-Sipmann, Fernando

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