Assessment of gradient between partial pressure of arterial carbon dioxide and end-tidal carbon dioxide in acute respiratory distress syndrome

IF 1 Q4 RESPIRATORY SYSTEM
Fatmaalzahraa Abdalrazik, M. Elghonemi
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引用次数: 3

Abstract

Context End-tidal carbon dioxide (EtCO2) is used as a noninvasive bedside test to assess the adequacy of ventilation and physiologic dead space in mechanically ventilated patients. The gradient difference between EtCO2 and partial pressure of arterial carbon dioxide (PaCO2) is directly related to an increase in the physiologic dead space. Aim The aim of this study was to evaluate the role of measuring the gradient between EtCO2 and PaCO2 in adults with acute respiratory distress (ARDS). Settings and design This was a prospective consecutive enrollment study. Patients and methods Overall, 51 cases were recruited after the diagnosis of ARDS was made according to the Berlin definition. Patients were mechanically ventilated as per the lung-protective protocol. Daily arterial blood gases were collected and for every sample, the EtCO2 value was collected electronically by capnography using an endotracheal tube for the first 5 days. Results Cases were classified into survivors and nonsurvivors: 26 cases were because of extrapulmonary causes and 25 cases were because of pulmonary causes. The mean value of the APACHE II score for all cases on admission was 21.6. The mean length of ICU stay was 12.7 days. For all study cases, PaO2/FiO2 was the lowest at day 1 and the highest at day 5. We found a significant negative correlation between PaO2/FiO2 and the gradient at days 2, 4, and day 5, and a significant positive correlation between the gradient on admission and the APACHE II score (r=0.4, P≤0.05). Nonsurvivors had a significantly higher gradient and lower EtCO2 and PaO2/FiO2 levels at all time intervals, whereas PaCO2 alone was found to be nonsignificant. Conclusion In ARDS, EtCO2 and gradient are reliable indicators of severity.
急性呼吸窘迫综合征中动脉二氧化碳分压与潮末二氧化碳梯度的评价
上下文潮气末二氧化碳(EtCO2)作为一种非侵入性床边测试,用于评估机械通气患者的通气和生理死区的充分性。EtCO2和动脉二氧化碳分压(PaCO2)之间的梯度差与生理死区的增加直接相关。目的本研究的目的是评估测量EtCO2和PaCO2之间的梯度在成人急性呼吸窘迫(ARDS)中的作用。设置和设计这是一项前瞻性的连续入组研究。患者和方法根据Berlin定义诊断为ARDS后,共招募51例患者。根据肺部保护方案对患者进行机械通气。每天收集动脉血气,对于每个样本,在头5天使用气管插管通过二氧化碳描记术以电子方式收集EtCO2值。结果病例分为存活者和非存活者:肺外原因26例,肺部原因25例。所有病例入院时APACHE II评分的平均值为21.6。ICU的平均住院时间为12.7天。对于所有研究病例,PaO2/FiO2在第1天最低,在第5天最高。我们发现PaO2/FiO2与第2天、第4天和第5天的梯度呈显著负相关,入院时的梯度与APACHE II评分呈显著正相关(r=0.4,P≤0.05)。在所有时间间隔内,非幸存者的梯度显著更高,EtCO2和PaO2/FiO2水平显著更低,而单独使用PaCO2并不显著。结论EtCO2和梯度是判断ARDS严重程度的可靠指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Egyptian Journal of Bronchology
Egyptian Journal of Bronchology RESPIRATORY SYSTEM-
自引率
7.70%
发文量
56
审稿时长
9 weeks
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