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The cut-offs identified in this study should be prospectively validated.Ĭopyright © 2023 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. These indices could be incorporated into clinical trials and used to identify patients who could benefit from early institution of adjunctive therapies. This association was independent of common confounding variables (OR, 1.33 95% CI, 1.12-1.58 p = 0.001 I2 = 66%).ĭead-space ventilation indices were independently associated with mortality in adults with ARDS. A high ventilatory ratio was also associated with increased mortality (OR, 1.55 95% CI, 1.33-1.80 p < 0.001 I2 = 48%). After adjusting for other confounding variables, every 0.05 increase in pulmonary-dead space fraction was associated with an increased odds of death (OR, 1.23 95% CI, 1.13-1.34 p < 0.001 I2 = 57%). A high pulmonary dead-space fraction was associated with increased mortality (odds ratio, 3.52 95% CI, 2.22-5.58 p < 0.001 I2 = 84%). We included 28 studies in our review, 21 of which were included in our meta-analysis. The quality and strength of evidence were assessed using the Quality in Prognostic Studies and Grading of Recommendations, Assessment, Development, and Evaluation, respectively. We calculated pooled effect estimates using a random effects model for both adjusted and unadjusted results. Two reviewers independently identified eligible studies and extracted data. Studies including adults with ARDS reporting a dead-space ventilation index and mortality. MEDLINE, CENTRAL, and Google Scholar from inception to November 2022. In this systematic review and meta-analysis, we evaluated the ability of dead-space ventilation measures to predict mortality in patients with ARDS. However, whether the degree of dead-space ventilation is associated with outcomes is uncertain. Acute respiratory distress syndrome (ARDS) is associated with high ventilation-perfusion heterogeneity and dead-space ventilation.
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