Dipartimento di Anestesia, Rianimazione e Terapia del dolore, Fondazione IRCCS, Cà Granda-Ospedale Maggiore Policlinico, Via F, Sforza 35, Milan, Italy.
Crit Care. 2010;14(5):195. doi: 10.1186/cc9237. Epub 2010 Sep 9.
Acute lung injury and acute respiratory distress syndrome are characterized by a non-cardiogenic pulmonary edema responsible for a significant impairment of gas exchange. The pulmonary dead space increase, which is due primarily to an alteration in pulmonary blood flow distribution, is largely responsible for carbon dioxide retention. Previous studies, computing the pulmonary dead space by measuring the expired carbon dioxide and the Enghoff equation, found that the dead space fraction was significantly higher in the non-survivors; it was even an independent risk of death. The computation of the dead space not by measuring the expired carbon dioxide but by applying a rearranged alveolar gas equation that takes into account only the weight, age, height, and temperature of the patient could lead to widespread clinical diffusion of this measurement at the bedside.
急性肺损伤和急性呼吸窘迫综合征的特征是无心源性肺水肿，导致气体交换显著受损。死腔增加主要是由于肺血流分布的改变所致，这在很大程度上导致了二氧化碳潴留。先前的研究通过测量呼气二氧化碳和 Enghoff 方程来计算肺死腔，发现非幸存者的死腔分数明显更高；它甚至是死亡的独立风险因素。通过应用仅考虑患者体重、年龄、身高和体温的重新排列的肺泡气方程而不是通过测量呼气二氧化碳来计算死腔，可以导致这种床边测量在临床上广泛传播。
