• Federica Fusina, Filippo Albani, Michele Bertelli, Erika Cavallo, Serena Crisci, Rosalba Caserta, Maia Nguyen, Michele Grazioli, Valeria Schivalocchi, Antonio Rosano, and Giuseppe Natalini.
• Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, Brescia, Italy. f.fusina@gmail.com.
• Respir Care. 2021 Apr 1; 66 (4): 619625619-625.

BackgroundThe ratio of dead space to tidal volume (VD/VT) is associated with mortality in patients with ARDS. Corrected minute ventilation ([Formula: see text]) is a simple surrogate of dead space, but, despite its increasing use, its association with mortality has not been proven. The aim of our study was to assess the association between [Formula: see text] and hospital mortality. We also compared the strength of this association with that of estimated VD/VT and ventilatory ratio.MethodsWe performed a retrospective study with prospectively collected data. We evaluated 187 consecutive mechanically ventilated subjects with ARDS caused by novel coronavirus disease (COVID-19). The association between [Formula: see text] and hospital mortality was assessed in multivariable logistic models. The same was done for estimated VD/VT and ventilatory ratio.ResultsMean ± SD [Formula: see text] was 11.8 ± 3.3 L/min in survivors and 14.5 ± 3.9 L/min in nonsurvivors (P < .001) and was independently associated with mortality (adjusted odds ratio 1.15, P = .01). The strength of association of [Formula: see text] with mortality was similar to that of VD/VT and ventilatory ratio.Conclusions[Formula: see text] was independently associated with hospital mortality in subjects with ARDS caused by COVID-19. [Formula: see text] could be used at the patient's bedside for outcome prediction and severity stratification, due to the simplicity of its calculation. These findings need to be confirmed in subjects with ARDS without viral pneumonia and when lung-protective mechanical ventilation is not rigorously applied.Copyright © 2021 by Daedalus Enterprises.

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