![]() ![]() Percentage of small vessels perfused (PPV) and microcirculatory flow index (MFI) were inverse and significantly related to V D/V T at baseline (Spearman's rho = - 0.76 and - 0.63, p < 0.001 R 2 = 0.63, and 0.48, p < 0.001, respectively) and 24 h after (Spearman's rho = - 0.71, and - 0.65 p < 0.001 R 2 = 0.66 and 0.60, p < 0.001, respectively). All measurements were repeated 24 h after. ![]() Sublingual microcirculatory images were simultaneously acquired using a sidestream dark-field device for an ulterior blinded semi-quantitative analysis. V D/V T was calculated from the CO 2 production () and CO 2 exhaled fraction () measurements by volumetric capnography. ![]() After 60 min of stabilization, hemodynamics and respiratory mechanics were recorded and blood gases collected. PEEP was set targeting the best respiratory-system compliance after a PEEP-decremental recruitment maneuver. We sought to evaluate the relationships between dynamic variations in V D/V T and extra-pulmonary microcirculatory blood flow detected at sublingual mucosa hypothesizing that an altered microcirculation, which is a generalized phenomenon during severe inflammatory conditions, could influence ventilation/perfusion mismatching manifested by increases in V D/V T fraction during early stages of ARDS.įorty-two consecutive patients with early moderate and severe ARDS were included. Although increased dead-space ventilation (V D/V T) has been described in ARDS, its mechanism is not clearly understood. Ventilation/perfusion inequalities impair gas exchange in acute respiratory distress syndrome (ARDS). ![]()
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