Predictive value of the physiological deadspace/tidal volume ratio in the weaning process of mechanical ventilation in children

OBJECTIVE: To evaluate the physiological deadspace/tidal volume ratio (VD/VT) as a predictor of extubation failure in 42 ventilated children (median age: 4.75 years). METHOD: Extubation readiness was determined using the criteria proposed by the 6th International Consensus Conference on Intensive Care Medicine adapted to children. RESULTS: Non-invasive ventilation (NIV) was used in four patients who developed respiratory failure after extubation; none was reintubated. Children who needed NIV to avoid reintubation had a significantly higher VD/VT ratio than those who were extubated without NIV (p < 0.001). The cut-off value of VD/VT ratio was 0.55 and the area under the receiver operating characteristic curve was 0.86. CONCLUSION: Our findings confirm the good predictive value of weaning success/failure of the VD/VT ratio and suggest its role for predicting the need for NIV after extubation.