1/28/2024 0 Comments Lung dead space locationOf these PEs, 8 were classified as central or lobar, 11 as segmental and 6 as subsegmental. The mean pre-CTPA PaO2/FiO2 (P/F ratio) was 134 mmHg (IQR 56.1). Therapeutic- dose anticoagulation was given before CTPA in 45.8% (n=22) of cases. Results: 48 CTPAs were included in the final analysis. Consultant radiologist reporting of the CTPA images was used as the reference standard for PE diagnosis. AVDSf values were derived from routine data taken at the closest available timepoint prior to the CTPA. All invasively ventilated patients with confirmed COVID-19 who underwent CTPA between March 2020 and April 2021 at a large UK intensive care unit were included. Methods: This was a retrospective, single-centre cohort study, delivered as a service evaluation with formal R&D approval and oversight (Ref S20HIP17). Objective: We sought to investigate the diagnostic utility of AVDSf prior to Computed Tomography Pulmonary Angiogram (CTPA) in invasively ventilated patients with COVID-19 and suspected PE. No studies have assessed the potential role of AVDSf in this diagnostic process. Patients with COVID-19 are at high risk of concurrent PE but diagnosis in invasively ventilated patients is challenging due to limitations with routine assessment, infection control issues and clinical instability. Research in the Emergency Department setting has shown that AVDSf can help exclude PE when combined with other diagnostic tests. Pulmonary embolism (PE) increases dead space and so it is hypothesised that AVDSf may be a useful diagnostic tool for PE. The AVDSf can be easily calculated in the intensive care unit using routinely documented data. ![]() This is commonly characterised as the alveolar dead space fraction (AVDSf), which is calculated using the equation (PaCO2 -ETCO2)/PaCO2. ABSTRACT Introduction: The difference between the end-tidal carbon dioxide (ETCO2) and arterial carbon dioxide (PaCO2) represents alveolar dead space.
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