Prognostication using SpO2/FiO2 in invasively ventilated ICU patients with ARDS due to COVID-19-Insights from the PRoVENT-COVID study

被引：8

作者：

Roozeman, Jan-Paul ^{[34
,35
]}

Mazzinari, Guido ^{[36
,37
]}

Neto, Ary Serpa ^{[34
,38
]}

Hollmann, Markus W. ^{[35
]}

Paulus, Frederique ^{[34
]}

Schultz, Marcus J. ^{[34
,35
,39
]}

Pisani, Luigi ^{[34
,40
,41
]}

Algera, A. G. ^{[1
]}

Boers, L. S. ^{[1
]}

Bos, L. D. J. ^{[1
]}

Botta, M. ^{[1
]}

Dongelmans, D. A. ^{[1
]}

Hollmann, M. W. ^{[2
]}

Horn, J. ^{[1
]}

Paulus, F. ^{[1
,3
]}

Pillay, J. ^{[1
,4
]}

Schultz, M. J. ^{[1
,5
,6
]}

Neto, A. Serpa ^{[7
]}

Tsonas, A. M. ^{[1
]}

Vlaar, A. P. J. ^{[1
]}

Ahuja, S. ^{[8
]}

van Akkeren, J. P. ^{[9
]}

Algoe, C. K. ^{[1
]}

van Amstel, R. B. ^{[1
]}

Artigas, A. ^{[10
]}

Baur, O. L. ^{[1
]}

van de Berg, P. ^{[11
]}

van den Berg, A. E. ^{[12
]}

Bergmans, D. C. J. J. ^{[13
]}

van den Bersselaar, D., I ^{[1
]}

Bertens, F. A. ^{[1
]}

Bindels, A. J. G. H. ^{[11
]}

de Boer, M. M. ^{[1
]}

den Boer, S. ^{[14
]}

Bogerd, M. ^{[1
]}

Breel, J. S. ^{[2
]}

de Bruin, H. ^{[1
]}

de Bruin, S. ^{[1
]}

Bruna, C. L. ^{[1
]}

Buiteman-Kruizinga, L. A. ^{[15
]}

Cremer, O. L. ^{[16
]}

Determann, R. M. ^{[17
]}

Dieperink, W. ^{[4
]}

Franke, H. S. ^{[4
]}

Galek-Aldridge, M. S. ^{[1
]}

de Graaff, M. J. ^{[18
]}

Hagens, L. A. ^{[1
]}

Haringman, J. J. ^{[19
]}

van der Heide, S. T. ^{[1
]}

van der Heiden, P. L. J. ^{[15
]}

机构：

[1] Univ Amsterdam, Locat Acad Med Ctr, Med Ctr, Dept Intens Care, Amsterdam, Netherlands

[2] Univ Amsterdam, Locat Acad Med Ctr, Med Ctr, Dept Anaesthesiol, Amsterdam, Netherlands

[3] Amsterdam Univ Appl Sci, Fac Hlth, Ctr Appl Res, ACHIEVE, Amsterdam, Netherlands

[4] Univ Med Ctr Groningen, Dept Intens Care, Groningen, Netherlands

[5] Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Bangkok, Thailand

[6] Univ Oxford, Nuffield Dept Med, Oxford, England

[7] Monash Univ, Australian & New Zealand Intens Care Res Ctr ANZ, Dept Crit Care Med, Melbourne, Vic, Australia

[8] Henry Ford Hlth Syst, Dept Anaesthesiol Pain Management Perioperat Med, Detroit, MI USA

[9] Maxima Med Ctr, Dept Intens Care, Eindhoven, Netherlands

[10] Sabadell Hosp, Crit Care Ctr, Sabadell, Spain

[11] Catharina Hosp, Dept Intens Care, Eindhoven, Netherlands

[12] Haga Hosp, Dept Intens Care, The Hague, Netherlands

[13] Maastricht Univ, Med Ctr, Dept Intens Care, Maastricht, Netherlands

[14] Spaarne Hosp, Dept Intens Care, Haarlem, Netherlands

[15] Reinier de Graaf Hosp, Dept Intens Care, Delft, Netherlands

[16] Univ Med Ctr Utrecht, Dept Intens Care, Utrecht, Netherlands

[17] OLVG Hosp, Dept Intens Care, Amsterdam, Netherlands

[18] St Antonius Hosp, Dept Intens Care, Nieuwegein, Netherlands

[19] Isala Hosp, Dept Intens Care, Zwolle, Netherlands

[20] Zuyderland Hosp, Dept Intens Care, Heerlen, Netherlands

[21] Zuyderland Hosp, Dept Intens Care, Sittard, Netherlands

[22] ZGT Hosp, Dept Intens Care, Almelo, Netherlands

[23] Med Ctr Leeuwarden, Dept Intens Care, Leeuwarden, Netherlands

[24] Maasstad Hosp, Dept Intens Care, Rotterdam, Netherlands

[25] Amphia Hosp, Dept Intens Care, Breda, Netherlands

[26] FlevoHosp, Dept Intens Care, Almere, Netherlands

[27] Gelre Hosp, Dept Intens Care, Apeldoorn, Netherlands

[28] Gelre Hosp, Dept Intens Care, Zutphen, Netherlands

[29] Rijnstate Hosp, Dept Intens Care, Arnhem, Netherlands

[30] Univ Amsterdam, Dept Intens Care, Med Ctr, Locat VU Med Ctr, Amsterdam, Netherlands

[31] Dijklander Hosp, Locat Hoorn, Dept Intens Care, Hoorn, Netherlands

[32] Haaglanden Med Ctr, Locat Westeinde, Dept Intens Care, The Hague, Netherlands

[33] Gelderse Vallei Hosp, Dept Intens Care, Ede, Netherlands

[34] Amsterdam UMC, Dept Intens Care, Locat AMC, Amsterdam, Netherlands

[35] Amsterdam UMC, Dept Anesthesiol, Locat AMC, Amsterdam, Netherlands

[36] Hosp Univ la Fe, Dept Anesthesiol, Valencia, Spain

[37] Inst Invest Sanitaria, Perioperat Med Res Grp, Valencia, Spain

[38] Hosp Israelita Albert Einstein, Dept Crit Care Med, Sao Paulo, Brazil

[39] Mahidol Univ, Fac Trop Med, Mahidol Oxford Res Unit MORU, Bangkok, Thailand

[40] Univ Bari Aldo Moro, Dept Emergency & Organ Transplantat, Anesthesia & Intens Care Unit, Bari, Italy

[41] Miulli Reg Hosp, Dept Anesthesiol & Intens Care Med, Acquaviva Delle Fonti, Italy

来源：

JOURNAL OF CRITICAL CARE | 2022年 / 68卷

关键词：

COVID-19; Acute respiratory distress syndrome; SpO(2)/FiO(2); Pulse oximetry; Mechanical ventilation; Resource limited settings; RESPIRATORY-DISTRESS-SYNDROME; RACIAL BIAS; RATIO; PAO2/FIO2;

D O I：

10.1016/j.jcrc.2021.11.009

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: The SpO(2)/FiO(2) is a useful oxygenation parameter with prognostic capacity in patients with ARDS. We investigated the prognostic capacity of SpO(2)/FiO(2) for mortality in patients with ARDS due to COVID-19. Methods: This was a post-hoc analysis of a national multicenter cohort study in invasively ventilated patients with ARDS due to COVID-19. The primary endpoint was 28-day mortality. Results: In 869 invasively ventilated patients, 28-day mortality was 30.1%. The SpO(2)/FiO(2) on day 1 had no prognostic value. The SpO(2)/FiO(2) on day 2 and day 3 had prognostic capacity for death, with the best cut-offs being 179 and 199, respectively. Both SpO(2)/FiO(2) on day 2 (OR, 0.66 [95%-CI 0.46-0.96]) and on day 3 (OR, 0.70 [95%-CI 0.51-0.96]) were associated with 28-day mortality in a model corrected for age, pH, lactate levels and kidney dysfunction (AUROC 0.78 [0.76-0.79]). The measured PaO2/FiO(2) and the PaO2/FiO(2) calculated from SpO(2)/FiO(2) were strongly correlated (Spearman's r = 0.79). Conclusions: In this cohort of patients with ARDS due to COVID-19, the SpO(2)/FiO(2) on day 2 and day 3 are independently associated with and have prognostic capacity for 28-day mortality. The SpO(2)/FiO(2) is a useful metric for risk stratification in invasively ventilated COVID-19 patients. (C) 2021 The Authors. Published by Elsevier Inc.

引用

页码：31 / 37

页数：7

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