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Corrections of Enghoff's dead space formula for shunt effects still overestimate Bohr's dead space.
MedLine Citation:
PMID:  23827851     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Dead space ratio is determined using Enghoff's modification (VDB-E/VT) of Bohr's formula (VDBohr/VT) in which arterial is used as a surrogate of alveolar PCO2. In presence of intrapulmonary shunt Enghoff's approach overestimates dead space. In 40 lung-lavaged pigs we evaluated the Kuwabara's and Niklason's algorithms to correct for shunt effects and hypothesized that corrected VDB-E/VT should provide similar values as VDBohr/VT. We analyzed 396 volumetric capnograms and arterial and mixed-venous blood samples to calculate VDBohr/VT and VDB-E/VT. Thereafter, we corrected the latter for shunt effects using Kuwabara's (K) VDB-E/VT and Niklason's (N) VDB-E/VT algorithms. Uncorrected VDB-E/VT (mean±SD of 0.70±0.10) overestimated VDBohr/VT (0.59±0.12) (p<0.05), over the entire range of shunts. Mean (K)VDB-E/VT was significantly higher than VDBohr/VT (0.67±0.08, bias -0.085, limits of agreement -0.232 to 0.085; p<0.05) whereas (N)VDB-E/VT showed a better correction for shunt effects (0.64±0.09, bias 0.048, limits of agreement -0.168 to 0.072; p<0.05). Neither Kuwabara's nor Niklason's algorithms were able to correct Enghoff's dead space formula for shunt effects.
Authors:
Fernando Suarez-Sipmann; Arnoldo Santos; Stephan H Böhm; Joao Batista Borges; Göran Hedenstierna; Gerardo Tusman
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-7-1
Journal Detail:
Title:  Respiratory physiology & neurobiology     Volume:  -     ISSN:  1878-1519     ISO Abbreviation:  Respir Physiol Neurobiol     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-7-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140022     Medline TA:  Respir Physiol Neurobiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier B.V.
Affiliation:
Department of Surgical Sciences, Section of Anesthesiology & Critical Care, Uppsala University, Uppsala, Sweden; Instituto de Investigación Sanitaria, Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain. CIBERES. Electronic address: fsuarez.sipmann@surgsci.uu.se.
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