Increased Ratio of Dead Space to Tidal Volume in Subjects With Inhalation Injury.
BACKGROUND: Inhalation injury increases morbidity and mortality in burn patients. Patients with inhalation injury present with large differences between end-tidal CO2 pressure and PaCO2, an indirect measure of dead space. We aimed to investigate the relationships between increased dead space and inh...
| Publicado en: | Respiratory Care Vol. 65; no. 10; pp. 1555 - 1561 |
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| Autores principales: | , , , , |
| Formato: | equations & formulas research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Oct2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=146059465&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 146059465 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Oct2020 vid: 65 iid: 10 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 146059465 146059465 146059465 10.4187/respcare.07515 146059465 ppf: 1555 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Increased Ratio of Dead Space to Tidal Volume in Subjects With Inhalation Injury. aug: au: Granchi, Thomas Lemere, Ashley Mashruwala, Neil Galet, Colette Romanowski, Kathleen S. affil: Department of Surgery, Acute Care Surgery Division, University of Iowa Hospitals & Clinic, Iowa City, Iowa sug: subj: Tidal Volume Smoke Inhalation Injury Respiratory Dead Space Human Retrospective Design Length of Stay Blood Gas Analysis Carbon Dioxide T-Tests Bivariate Statistics Correlational Studies Descriptive Statistics Middle Age Mortality Illinois Nonparametric Statistics Mann-Whitney U Test Multiple Linear Regression Data Analysis Software Middle Aged: 45-64 years ab: BACKGROUND: Inhalation injury increases morbidity and mortality in burn patients. Patients with inhalation injury present with large differences between end-tidal CO2 pressure and PaCO2, an indirect measure of dead space. We aimed to investigate the relationships between increased dead space and inhalation injury outcomes. METHODS: This retrospective study included 51 adult subjects with burns and inhalation injuries. Demographics, size of burns, length of stay, ventilator days, blood gas results, end-tidal CO2 pressure, presence of ventilator-associated pneumonia, and mortality data were collected. Modified Baux scores and ratios of alveolar dead space to alveolar tidal volume (VDalv/VTalv) were calculated. Independent t tests were used to compare mean VDalv/VTalv of survivors to that of subjects who died and between subjects with and without pneumonia. The relationships between VDalv/VTalv and ventilator days or modified Baux score were assessed with bivariate correlation analysis. RESULTS: Our population had a mean age of 52 y and an average burn size of 17.5%. The average length of stay and ventilator days were 12 d and 3.8 d, respectively. The mean modified Baux score was 87. The mean VDalv/VTalv was 0.38. Ten subjects died, and 6 subjects had pneumonia. The VDalv/VTalv of survivors was significantly smaller for survivors than for subjects who died (0.34 vs 0.52, P = .03). No significant difference was observed between subjects with and without pneumonia (0.36 vs 0.47, P = .26). VDalv/VTalv correlated significantly with modified Baux score (r = .524, P < .001). CONCLUSIONS: Alveolar dead space (VDalv/VTalv) is easily calculated from PaCO2 and end-tidal CO2 pressure and may be useful in assessing severity of inhalation injury, the patient's prognosis, and the patient's response to treatment. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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