Document Detail

Evaluation of the dead space/tidal volume ratio in patients with chronic congestive heart failure.
MedLine Citation:
PMID:  12836715     Owner:  NLM     Status:  MEDLINE    
Dead space/tidal volume ratio (VD/VT) evaluation is currently performed in patients with respiratory and cardiac disorders, and includes measurement of arterial CO2 partial pressure (PaCO2). PaCO2 is generally derived from either PETCO2 (end-expiratory CO2 pressure) or PJCO2 (calculated as PJCO2 = 5.5 + 0.9 PETCO2 - 2.1 VT). The applicability of these methods may be questionable in chronic heart failure due to its frequent association with lung dysfunction. In 63 patients with congestive heart failure, the authors compared PaCO2 versus PETCO2 and PJCO2 and VD/VT measured with PaCO2 versus VD/VT estimated with PETCO2 (estimation 1) or PJCO2 (estimation 2). Comparisons were made at rest, at submaximal exercise, and at peak exercise. Considering all 326 measurements, there was a strong correlation, but not an identity, between PaCO2 and PETCO2 (PaCO2 = 7.25 + 0.80 PETCO2, r = .84, P < .0001) and between PaCO2 and PJCO2 (PaCO2 = 6.18 + 0.84 PJCO2, r = .85, P < .0001). Results were comparable concerning PaCO2 versus PJCO2. Measured VD/VTs also strongly correlated with estimated VD/VTs (VD/VT measured = -0.03 + 1.11 VD/VT [estimation 1], r = .90, P < .0001, and VD/VT measured = 0.03 + 0.92 VD/VT [estimation 2], r = .90, P < .0001). However, only at rest and, solely for estimation 1, at submaximal exercise were the slopes and y intercepts of measured versus estimated VD/VT not different from 1 and 0, respectively; in this regard, lung dysfunction was more influential than the severity of cardiac failure. Although PaCO2 strongly correlates with PETCO2 and PJCO2, these measurements may not be reliable for a noninvasive calculation of VD/VT in chronic congestive heart failure.
M Guazzi; G Marenzi; E Assanelli; G B Perego; G Cattadori; E Doria; P G Agostoni
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  1     ISSN:  1071-9164     ISO Abbreviation:  J. Card. Fail.     Publication Date:  1995 Dec 
Date Detail:
Created Date:  2003-07-02     Completed Date:  2003-07-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  401-8     Citation Subset:  IM    
Istituto di Cardiologia dell' Università degli Studi, Centro di Studio per le Ricerche Cardiovascolari del CNR, Fondazione Monzino, IRCSS, Milan, Italy.
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MeSH Terms
Carbon Dioxide / blood
Chronic Disease
Exercise Test
Heart Failure / physiopathology*
Linear Models
Middle Aged
Oxygen Consumption / physiology
Partial Pressure
Respiratory Dead Space / physiology*
Tidal Volume / physiology*
Reg. No./Substance:
124-38-9/Carbon Dioxide

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