Journal Information
Share
Share
Download PDF
More article options
Visits
12
Original article
Available online 21 June 2024
Association of dead space fraction to mortality in patients with COVID-19-related ARDS: A historical cohort observational study
Asociación de Fracción de Espacio Muerto con la Mortalidad en Pacientes con SDRA por COVID-19: Un estudio observacional de una cohorte histórica
Visits
12
Carlos Carvajala,b,
Corresponding author
ccarvajal@hptu.org.co

Corresponding author.
, Nelson Darío Giraldo Ramireza,b, Andrés David De La Hoz Castrod, Carlos Guillermo Vidal Vargasc,d, Hemel Antonio Pachecoc,d, David Fernández Sánchezd, Laura Vannesa González Salazarc,d, Silvia Stella Romero Ottad, Silvia Vergara Jaimesc,d, Juan Fernando Bolivar Ospinac,d, Juliana Correa Céspedesc,d, Alejandro Narvaez Orozcod, Jorge Hernando Donadoa,c, Carlos Alberto Cadavida,b, Gisela De La Rosaa,b
a Hospital Pablo Tobón Uribe, Medellín, Antioquia, Colombia
b Departamento de Cuidado Crítico de adulto
c Departamento de Investigación
d Estudiante de Medicina, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (2)
Table 1. Demographic, clinical and ventilatory characteristics of the COVID-19 patients with ARDS on the first day of mechanical ventilation.
Table 2. Multivariate Cox regression analysis.
Show moreShow less
Abstract
Objective

To assess the correlation of dead space fraction (VD/VT) measured through time capnography, corrected minute volume (CMV) and ventilation ratio (VR) with clinical outcomes in COVID-19 patients requiring invasive mechanical ventilation.

Design

Observational study of a historical cohort.

Setting

University hospital in Medellin, Colombia.

Participants

Patients aged 15 and above with a confirmed COVID-19 diagnosis admitted to the ICU and requiring mechanical ventilation.

Interventions

Measurement of VD/VT, CMV, and VR in COVID-19 patients.

Main variables of interest

VD/VT, CMV, VR, demographic data, oxygenation indices and ventilatory parameters.

Results

During the study period, 1047 COVID-19 patients on mechanical ventilation were analyzed, of whom 446 (42%) died. Deceased patients exhibited a higher prevalence of advanced age and obesity, elevated Charlson index, higher APACHE II and SOFA scores, as well as an increase in VD/VT ratio (0.27 in survivors and 0.31 in deceased) and minute ventilation volume on the first day of mechanical ventilation. The multivariate analysis revealed independent associations to in-hospital mortality, higher VD/VT (HR 1.24; 95%CI 1.003–1.525; p = 0.046), age (HR 1.024; 95%CI 1.014–1.034; p < 0.001), and SOFA score at onset (HR: 1.036; 95%CI: 1.001–1.07; p = 0.017).

Conclusions

VD/VT demonstrated an association with mortality in COVID-19 patients with ARDS on mechanical ventilation. These findings suggest that VD/VT measurement may serve as a severity marker for the disease.

Keywords:
COVID-19
VD/VT (dead space fraction)
Invasive mechanical ventilation
Mortality
ARDS (acute respiratory distress syndrome)
Resumen
Objetivo

Evaluar la asociación entre la fracción del espacio muerto (VD/VT) medida mediante capnografía de tiempo, el volumen minuto corregido (VMC) y la razón ventilatoria (RV) con los desenlaces clínicos en pacientes con COVID-19 que requirieron ventilación mecánica invasiva (VMI).

Diseño

Estudio observacional de una cohorte histórica.

Ámbito

Hospital universitario en Medellín, Colombia.

Participantes

Pacientes mayores de 15 años con diagnóstico confirmado de COVID-19 que fueron admitidos en la UCI y necesitaron VMI.

Intervenciones

Medición de VD/VT, VMC y RV en pacientes con COVID-19.

Variables de interés principales

VD/VT, VMC, RV, datos demográficos, índices de oxigenación y parámetros ventilatorios.

Resultados

Durante el período de estudio se analizaron 1.047 pacientes con COVID-19 en VMI, de los cuales fallecieron 446 (42%). En los fallecidos se observó una mayor prevalencia de edad avanzada y obesidad, un índice de Charlson más elevado, mayor APACHE II y SOFA, así como un aumento en el VD/VT (0,27 en vivos y 0,31 en fallecidos) y del volumen minuto en el primer día de VMI. El análisis multivariado mostró una asociación independiente con mortalidad hospitalaria, mayor VD/VT (HR 1,24; IC 95% 1,003-1,525; p = 0,046), edad (HR 1,024; IC 95% 1,014-1,034; p < 0,001) y SOFA al inicio (HR: 1,036; IC 95%: 1,001-1,07; p = 0,017).

Conclusiones

La VD/VT mostró una asociación con la mortalidad en pacientes con SDRA por COVID-19 en VMI. Estos hallazgos sugieren que la medición de la VD/VT puede servir como marcador de gravedad de la enfermedad.

Palabras clave:
COVID-19
VD/VT (Fracción de Espacio Muerto)
Ventilación Mecánica Invasiva
Mortalidad
Síndrome de Dificultad Respiratoria Aguda (SDRA)

Article

These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
Member
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC (www.semicyuc.org )and click the link to the magazine.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Intensiva (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Medicina Intensiva (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?