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

J Pediatr (Rio J). 2012 May;88(3):217-21. doi: 10.2223/JPED.2190. Epub 2012 May 23.


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.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Airway Extubation*
  • Child
  • Child, Preschool
  • Critical Care*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Noninvasive Ventilation
  • Predictive Value of Tests
  • ROC Curve
  • Respiratory Dead Space / physiology
  • Respiratory Insufficiency / therapy*
  • Tidal Volume / physiology
  • Ventilator Weaning*