Identification of focal ARDS using ventilatory ratio

Abstract

Dear Editor Acute respiratory distress syndrome (ARDS) patients with disease predominantly in the posterobasal lung regions (i.e., focal ARDS) benefited from prone positioning, while patients with diffuse (non-focal) ARDS benefited from recruitment maneuvers and high positive end-expiratory pressures, provided focal ARDS was correctly classified [1]. Admission diagnoses were as follows: pneumonia (61 patients; 40.1%), non-pneumonia sepsis (19; 12.5%), chronic obstructive pulmonary disease (9; 5.9%), acute myocardial infarction (3; 2.0%), stroke (12; 7.9%), other diagnoses such as massive hemoptysis, pulmonary vasculitis and pneumonitis (48; 32.6%). A VR of < 1.2 was associated with focal ARDS (odds ratio 3.41, 95% confidence interval 1.05–11.1, P = 0.041), with sensitivity 31.3%, specificity 88.3%, positive predictive value 23.8%, and negative predictive value 91.6%.