20, 21 Another is the ventilatory ratio, which compares arterial partial pressure of CO 2 ( ) and minute ventilation to corresponding “ideal” and “predicted” values as a signifier for V D/V T. 18, 19 Surrogate measures for estimating V D/V T now are commonly utilized and include versions of the Harris-Benedict or other equations. Unfortunately, it has been our perception that, despite both the clinical value of V D/V T and wide access to indirect calorimetry and volumetric capnography monitors, measuring V D/V T has not been universally embraced by the larger critical care community. 2- 9 Others have demonstrated the value of using V D/V T measurements to detect lung recruitment and de-recruitment, 10- 14 as well as insight into the effects of pharmacologic therapies for ARDS. Since then, numerous studies have confirmed and expanded these findings. The seminal study by Nuckton and colleagues 1 demonstrated that the ratio of physiologic dead space to tidal volume (V D/V T) at ARDS onset was a strong, independent predictor of mortality risk.
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