V D/ V T was calculated from the CO 2 production ( \(V_\) performed by the module were automatically corrected for circuit compression, as described elsewhere. 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. Methodsįorty-two consecutive patients with early moderate and severe ARDS were included. 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. 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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