In addition, measured mixed expired P co 2 requires correction for compressed ventilator gas that contaminates the expired volume. 6 7 The traditional method of calculating physiological dead space is cumbersome and requires a large chamber (Douglas Bag) for the collection of mixed expired gas. This may in part be because volumetric capnographs are not integrated as standard in most commonly used ventilators and installation incurs additional expense. Despite being available for over two decades, it has failed to gain popularity in intensive care practice. Volumetric capnography offers a relatively simple method of calculating dead space. In the main, this is due to problems associated with measuring dead space. 1, 2, 3, 4, 5 Yet in day-to-day practice, deadspace measurements are seldom performed. Increased deadspace ventilation has consistently been shown to be associated with increased mortality and disease progression in patients with acute respiratory distress syndrome (ARDS). Deadspace measurement is the most accurate surrogate for assessing ventilatory inefficiency. ![]() It is intuitive that monitoring ventilatory efficiency will be of considerable importance in the management of mechanically ventilated patients. Alveolar ventilation is the portion of the tidal volume that participates in gas exchange and defines ventilatory efficiency.
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