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EDITORIAL |
Editorial II: Deadspace: invasive or not?
1 Edinburgh, UK
2 Cheadle, UK
* Corresponding author. E-mail: g.b.drummond@ed.ac.uk
| The first 150 words of the full text of this article appear below. |
The recent paper by Tang and colleagues1 brought a refreshing discipline to measurements of respiratory deadspace. With capnography being widely available and more sophisticated, respiratory deadspace is more relevant in anaesthesia and intensive care, and physiological deadspace may become an important clinical measurement. In a recent study of patients in the first day of onset of ARDS, increased physiological deadspace fraction was an independent and powerful predictor of mortality.2 The relative risk of death increased by 45% if deadspace was increased by 5%. This increased risk was greater than for other predictive features, such as a score of illness severity or respiratory compliance. However, oxygenation was also significantly worse in the non-survivors (more of which will be explained later).
Deadspace can be calculated invasively or non-invasively: the difference may be subtle but very important, particularly in lung disease. Non-invasive information is obtained from the carbon dioxide single breath test (SBT-CO2
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