by Mingjia Zheng
Critical Care volume 27,
Article number: 46 (2023)
Abstract
Cumulative evidence has demonstrated that the ventilatory
ratio closely correlates with mortality in acute respiratory distress syndrome
(ARDS), and a primary feature in coronavirus disease 2019 (COVID-19)-ARDS is
increased dead space that has been reported recently. Thus, new attention has
been given to this group of dead space ventilation-related indices, such as
physiological dead space fraction, ventilatory ratio, and end-tidal-to-arterial
PCO2 ratio, which, albeit distinctive, are all global indices with which
to assess the relationship between ventilation and perfusion. These parameters
have already been applied to positive end expiratory pressure titration,
prediction of responses to the prone position and the field of extracorporeal
life support for patients suffering from ARDS. Dead space ventilation-related
indices remain hampered by several deflects; notwithstanding, for this
catastrophic syndrome, they may facilitate better stratifications and
identifications of subphenotypes, thereby providing therapy tailored to
individual needs.
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