{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T19:07:23Z","timestamp":1786820843120,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      The dead-space-to-tidal-volume ratio (V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      ) has been used to successfully predict extubation failure in children who are critically ill. However, a singular reliable measure to predict the level and duration of respiratory support after liberation from invasive mechanical ventilation has remained elusive. The objective of this study was to evaluate the association between V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      and the duration of postextubation respiratory support.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      This was a retrospective cohort study of subjects who were mechanically ventilated and admitted to a single-center pediatric ICU between March 2019 and July 2021, and who had been extubated with a recorded V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      . A cutoff of 0.30 was chosen a priori, with subjects divided into 2 groups, V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      &lt; 0.30 and V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      \u2265 0.30, and postextubation respiratory support was recorded at specified time intervals (24 h, 48 h, 72 h, 7 d, and 14 d).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We studied 54 subjects. Those with V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      \u2265 0.30 had a significantly longer median (interquartile range) duration of respiratory support after extubation (6 [3\u201314] d vs 2 [0\u20134] d;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001) and longer median (interquartile range) ICU stay (14 [12\u201319] d vs 8 [5\u201322] d;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .046) versus the subjects with V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      &lt; 0.30. The distribution of respiratory support did not differ significantly between V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      at the time of extubation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .13) or at 14 d after extubation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .21) but was significantly different during the intervening time points after extubation (24 h [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01], 48 h [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001], 72 h [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001], and 7 d [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      was associated with the duration and level of respiratory support needed after extubation. Prospective studies are needed to establish if V\n                      <jats:sub>D<\/jats:sub>\n                      \/V\n                      <jats:sub>T<\/jats:sub>\n                      can successfully predict the level of respiratory support after extubation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.10550","type":"journal-article","created":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T15:40:57Z","timestamp":1686066057000},"page":"1519-1526","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Association Between Dead Space to Tidal Volume Ratio and Duration of Respiratory Support After Extubation in Critically Ill Children"],"prefix":"10.1177","volume":"68","author":[{"given":"Alexandra C","family":"Feldman","sequence":"first","affiliation":[{"name":"Division of Critical Care, Ann &amp; Robert Lurie Children's Hospital of Chicago and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University, Durham, North Carolina."},{"name":"Respiratory Care Services, Duke University, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre T","family":"Rotta","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle J","family":"Rehder","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan R","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Duke University, Durham, North Carolina."},{"name":"Duke Clinical Research Institute, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(18)30375-8"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.5935\/0103-507X.20180046"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201807-502CME"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e318247f6cc"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-013-9433-x"},{"issue":"4","key":"e_1_3_2_7_2","first-page":"372","article-title":"Relationship between physiologic deadspace\/tidal volume ratio and gas exchange in infants with acute bronchiolitis on invasive mechanical ventilation","volume":"8","author":"Almeida-Junior AA","year":"2007","unstructured":"Almeida-Junior AA, , da Silva MT, , Almeida CCB, , Ribeiro JD. Relationship between physiologic deadspace\/tidal volume ratio and gas exchange in infants with acute bronchiolitis on invasive mechanical ventilation. 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