V D/ V T was calculated from the CO 2 production ( \(V_\) performed by the module were automatically corrected for circuit compression, as described elsewhere. After 60 min of stabilization, hemodynamics and respiratory mechanics were recorded and blood gases collected. PEEP was set targeting the best respiratory-system compliance after a PEEP-decremental recruitment maneuver. Methodsįorty-two consecutive patients with early moderate and severe ARDS were included. We sought to evaluate the relationships between dynamic variations in V D/ V T and extra-pulmonary microcirculatory blood flow detected at sublingual mucosa hypothesizing that an altered microcirculation, which is a generalized phenomenon during severe inflammatory conditions, could influence ventilation/perfusion mismatching manifested by increases in V D/ V T fraction during early stages of ARDS. Although increased dead-space ventilation ( V D/ V T) has been described in ARDS, its mechanism is not clearly understood. Hopefully the components of that volume of air will be clearer after reviewing the following illustrations.Ventilation/perfusion inequalities impair gas exchange in acute respiratory distress syndrome (ARDS). And then real quick before we dive in: if you’re not familiar with the idea of dead space in general, it’s the concept that there is a difference between the quantity of air breathed in during a breath (tidal volume) and the volume of air that actually participates in gas exchange at the alveolar level (clinically relevant tidal volume). Dead space is a concept that we generally discuss in the context of mechanical ventilation – this short series of graphics won’t get into too much detail on that, but we can point you towards our free book on the idea: The goal here is simply to review the different types of dead space, demonstrate them graphically, and point out specific interventions for each of the various types. The series of illustrations in this post demonstrate the different types of dead space encountered in clinical practice and interventions to address them.
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