Corrections of Enghoff's dead space formula for shunt effects still overestimate Bohr's dead space

  • Suarez-Sipmann F
  • Santos A
  • Böhm S
 et al. 
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Abstract

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

Author-supplied keywords

  • Acute lung injury
  • Bohr's formula
  • Dead space
  • PEEP
  • Shunt
  • Vd/Vt

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Authors

  • Fernando Suarez-Sipmann

  • Arnoldo Santos

  • Joao Batista Borges

  • Göran Hedenstierna

  • Gerardo Tusman

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