| Title |
Analysis of ventilatory ratio as a novel method to monitor ventilatory adequacy at the bedside
|
|---|---|
| Published in |
Critical Care, February 2013
|
| DOI | 10.1186/cc12541 |
| Pubmed ID | |
| Authors |
Pratik Sinha, Nicholas J Fauvel, Pradeep Singh, Neil Soni |
| Abstract |
INTRODUCTION: Due to complexities in its measurement, adequacy of ventilation is seldom used to categorize disease severity and guide ventilatory strategies. Ventilatory ratio (VR) is a novel index to monitor ventilatory adequacy at the bedside. VR=(V˙Emeasured×PaCO2measured)/(V˙Epredicted×PaCO2ideal). V˙Epredicted is 100 mL.Kg-1.min-1 and PaCO2ideal is 5 kPa. Physiological analysis shows that VR is influenced by dead space (VD/VT) and CO2 production (V˙CO2). Two studies were conducted to explore the physiological properties of VR and assess its use in clinical practice. METHODS: Both studies were conducted in adult mechanically ventilated ICU patients. In Study 1, volumetric capnography was used to estimate daily VD/VT and measure V˙CO2 in 48 patients. Simultaneously, ventilatory ratio was calculated using arterial blood gas measurements alongside respiratory and ventilatory variables. This data was used to explore the physiological properties of VR. In Study 2, 224 ventilated patients had daily VR and other respiratory variables, baseline characteristics, and outcome recorded. The database was used to examine the prognostic value of VR. RESULTS: Study 1 showed that there was significant positive correlation between VR and VD/VT (modified r = 0.71) and V˙CO2 (r = 0.14). The correlation between VR and VD/VT was stronger in mandatory ventilation compared to spontaneous ventilation. Linear regression analysis showed that VD/VT had a greater influence on VR than V˙CO2 (standardized regression coefficient 1/1-VD/VT: 0.78, V˙CO2: 0.44). Study 2 showed that VR was significantly higher in non-survivors compared to survivors (1.55 vs. 1.32; P < 0.01). Univariate logistic regression showed that higher VR was associated with mortality (OR 2.3, P < 0.01), this remained the case after adjusting for confounding variables (OR 2.34, P = 0.04). CONCLUSIONS: VR is an easy to calculate bedside index of ventilatory adequacy and appears to yield clinically useful information. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 33% |
| United States | 1 | 33% |
| Unknown | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Hungary | 1 | 3% |
| France | 1 | 3% |
| Brazil | 1 | 3% |
| Unknown | 36 | 92% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 9 | 23% |
| Researcher | 7 | 18% |
| Student > Ph. D. Student | 5 | 13% |
| Student > Bachelor | 2 | 5% |
| Student > Doctoral Student | 2 | 5% |
| Other | 3 | 8% |
| Unknown | 11 | 28% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 20 | 51% |
| Nursing and Health Professions | 3 | 8% |
| Arts and Humanities | 1 | 3% |
| Social Sciences | 1 | 3% |
| Engineering | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 13 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 March 2016.
All research outputs
#7,047,954
of 25,374,917 outputs
Outputs from Critical Care
#3,932
of 6,554 outputs
Outputs of similar age
#55,389
of 205,195 outputs
Outputs of similar age from Critical Care
#51
of 169 outputs
Altmetric has tracked 25,374,917 research outputs across all sources so far. This one has received more attention than most of these and is in the 71st percentile.
So far Altmetric has tracked 6,554 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
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We're also able to compare this research output to 169 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.