engleski

Vd/Vt test in the detection of pulmonary dysfunction in sepsis

Dyspnea and tachypnea are the leading signs of pulmonary dysfunction in sepsis. With regards to present knowledge of pathophysiology and pathogenesis of the pulmonary dysfunction, the real reasons for this phenomena are still not researched enough. It is our assumption that one of the underlying causes is in the increased ventilation of the physiological dead space due to the mismatch of the pulmonary ventilation and perfusion. In sepsis, equal to change in systemic, there are changes in pulmonary circulation, often with pulmonary hypotension and decreased pulmonary vascular resistance. To investigate this we used a simple test to measure the ventilation of the dead space using the Vd/Vt test.In all subjects an increased (> 0.40) Vd/Vt index was found (0.50 &plusmn ; ; 0.05). Minute ventilation was also increased (13 &plusmn ; ; 1.4 l). We compared these results with arterial oxygen (PaO2) partial pressure and found a high degree of negative linear correlation for the Vd/Vt index and PaO2 (r = -0.7512, P < 0.01). A positive linear correlation for the Vd/Vt index and MV (r = 0.5862, P < 0.01) was also found.We believe that our results indicate that dyspnea and tachypnea in sepsis are mostly a result of the increased physiological dead space ventilation and that this test is useful for early detection and objectification of the pulmonary dysfunction in sepsis. The simplicity of this method makes it suitable for large-scale clinical use.

physiological dead space; pulmonary dysfunction; sepsis

01/0112910