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Williams E, Dassios T, Dixon P, et al. Physiological dead space and alveolar ventilation in ventilated infants. Pediatr Res. 2021;doi: 10.1038/s41390-021-01388-8.
Williams, E., Dassios, T., Dixon, P., & Greenough, A. (2021). Physiological dead space and alveolar ventilation in ventilated infants. Pediatric research, . https://doi.org/10.1038/s41390-021-01388-8
Williams, Emma, et al. "Physiological dead space and alveolar ventilation in ventilated infants." Pediatric research vol. (2021). doi: https://doi.org/10.1038/s41390-021-01388-8
Williams E, Dassios T, Dixon P, Greenough A. Physiological dead space and alveolar ventilation in ventilated infants. Pediatr Res. 2021 Feb 18; doi: 10.1038/s41390-021-01388-8. Epub 2021 Feb 18. PMID: 33603211; PMCID: PMC7891488.
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Pediatr Res. 2021 Feb 18; doi: 10.1038/s41390-021-01388-8. Epub 2021 Feb 18.

Physiological dead space and alveolar ventilation in ventilated infants.

Pediatric research

Emma Williams, Theodore Dassios, Paul Dixon, Anne Greenough

Affiliations

  1. Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
  2. Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, UK.
  3. Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK.
  4. Individual Consultant, London, UK.
  5. Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. [email protected].
  6. Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, UK. [email protected].
  7. NIHR Biomedical Centre at Guy's and St Thomas NHS Foundation Trust, King's College London, London, UK. [email protected].

PMID: 33603211 PMCID: PMC7891488 DOI: 10.1038/s41390-021-01388-8

Abstract

BACKGROUND: Dead space is the volume not taking part in gas exchange and, if increased, could affect alveolar ventilation if there is too low a delivered volume. We determined if there were differences in dead space and alveolar ventilation in ventilated infants with pulmonary disease or no respiratory morbidity.

METHODS: A prospective study of mechanically ventilated infants was undertaken. Expiratory tidal volume and carbon dioxide levels were measured. Volumetric capnograms were constructed to calculate the dead space using the modified Bohr-Enghoff equation. Alveolar ventilation (V

RESULTS: Eighty-one infants with a median (range) gestational age of 28.7 (22.4-41.9) weeks were recruited. The dead space [median (IQR)] was higher in 35 infants with respiratory distress syndrome (RDS) [5.7 (5.1-7.0) ml/kg] and in 26 infants with bronchopulmonary dysplasia (BPD) [6.4 (5.1-7.5) ml/kg] than in 20 term controls with no respiratory disease [3.5 (2.8-4.2) ml/kg, p < 0.001]. Minute ventilation was higher in both infants with RDS or BPD compared to the controls. V

CONCLUSION: Prematurely born infants with pulmonary disease have a higher dead space than term controls, which may influence the optimum level during volume-targeted ventilation.

IMPACT: Measurement of the dead space was feasible in ventilated newborn infants. The physiological dead space was a significant proportion of the delivered volume in ventilated infants. The dead space (per kilogram) was higher in ventilated infants with respiratory distress syndrome or evolving bronchopulmonary dysplasia compared to term controls without respiratory disease. The dead space volume should be considered when calculating the most appropriate volume during volume-targeted ventilation.

© 2021. The Author(s).

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