NIH Reporter #1R03HD110889-01A1

Alveolar Dead Space and New or Progressive MODS

This award funds research on the relationship between alveolar dead space and new or progressive multiple organ dysfunction syndrome (NPMODS) in critically ill children, aiming to improve prognostic tools for microvascular dysfunction and NPMODS.

Description

Multiple organ dysfunction syndrome (MODS) is common at ICU admission in children (25%). Some develop NPMODS during ICU management, doubling mortality risk. NPMODS is linked to systemic inflammation and microvascular dysfunction. No bedside methods currently detect microvascular dysfunction or high NPMODS risk. Alveolar dead space (DS) is a marker of alveoli receiving ventilation without perfusion, reflecting pulmonary microvascular dysfunction. It can be measured via blood gas and capnography in ventilated children. Elevated alveolar DS correlates with mortality, independent of oxygenation defect or cardiovascular issues, and is associated with microvascular dysfunction markers and NPMODS. The hypothesis is that elevated alveolar DS indicates higher NPMODS risk, primarily via microvascular pathways. The study aims to assess the relationship between alveolar DS and NPMODS, adjusting for other factors, and explore the association between microvascular dysfunction markers and NPMODS/alveolar DS. Data from a cohort of ventilated critically ill children at high NPMODS risk will be used, with longitudinal plasma samples and DS measurements. The goal is to improve prognostic and predictive tools for microvascular dysfunction and NPMODS reduction.

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