![]() ![]() ![]() 14 In children, V D/V T has been used as a marker of severity of lung disease 15, 16 and as a method to trend gas exchange in the lungs of neonates requiring extracorporeal membranous oxygenation, 17 and it is associated with prolonged duration of mechanical ventilation. A quantitative assessment of physiologic dead space, V D/V T has been reported to have utility in predicting extubation failure in adults, 8, 9 as well as prognosticating in ARDS 10- 13 and measuring the impact of bronchodilators in COPD. Normal V D/V T ranges from 0.25 to 0.4, whereas V D/V T > 0.4 (ie, more dead space) suggests pulmonary pathology. Physiologic dead space represents the portion of the respiratory tract that does not participate in gas exchange. One such proposed tool is the ratio of dead space to tidal volume (V D/V T). Furthermore, improved ability to predict those at risk for extubation failure may influence the choice of postextubation respiratory support. Validated extubation tools that quantify pulmonary disease may help reduce the incidence of failed extubation and thus may limit morbidity and potentially mortality. 2, 4, 6 Currently, there is no one tool that reliably predicts successful extubation in children. 1- 7 The need for re-intubation has been associated with increased duration of mechanical ventilation, length of hospital and ICU stay, and mortality. ![]() Extubation failure occurs in 4–14% of mechanically ventilated pediatric patients. ![]()
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