Over the past two decades, there has been increasing interest in dead space since the publication by Nuckton et al. Dead space ventilation-related indices remain hampered by several deflects notwithstanding, for this catastrophic syndrome, they may facilitate better stratifications and identifications of subphenotypes, thereby providing therapy tailored to individual needs.Ī hallmark of classical ARDS is an increased shunt caused by alveolar collapse and/or alveolar flooding from a physiological viewpoint. These parameters have already been applied to positive end expiratory pressure titration, prediction of responses to the prone position and the field of extracorporeal life support for patients suffering from ARDS. Thus, new attention has been given to this group of dead space ventilation-related indices, such as physiological dead space fraction, ventilatory ratio, and end-tidal-to-arterial PCO 2 ratio, which, albeit distinctive, are all global indices with which to assess the relationship between ventilation and perfusion. Hypoxemia and hypoxia do not always coexist. It can be due to either defective delivery or defective utilization of oxygen by the tissues.
Cumulative evidence has demonstrated that the ventilatory ratio closely correlates with mortality in acute respiratory distress syndrome (ARDS), and a primary feature in coronavirus disease 2019 (COVID-19)-ARDS is increased dead space that has been reported recently. Hypoxemia is defined as a decrease in the partial pressure of oxygen in the blood whereas hypoxia is defined by reduced level of tissue oxygenation.
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