ARDS severity identification based on noninvasive parameter SpO2/FiO2 / 医疗卫生装备

ABSTRACT

Objective To explore the relationship between SpO2/FiO2(S/F) and PaO2/FiO2(P/F) so as to determine the possibility of ARDS severity identification based on noninvasive parameters. Methods The physiological parameters of corresponding patients were acquired from Medical Information Mart for Intensive Care (MIMIC-Ⅲ),and then divided into a training set and a test set randomly.In the training set the linear relationship between lg(S/F)and lg(P/F)was established with generalized linear regression model,and a log linear regression model was formed with the optimal regression equation;the linear relationship between lg(S/F)and lg(P/F)was compared with that between S/F and P/F.In the test set,the two models were compared on the identification of ARDS in case P/F values were 100(mild ARDS),200(moderate ARDS)and 300(severe ARDS)respectively.Results In the training set(n=61 634)the linear relationship between lg(S/F)and lg(P/F)was deduced as lg(S/F)=1.277+0.437×lg(P/F) (r=0.66,P<0.000 1),and the S/F thresholds in case P/F values were 100,200 and 300 respectively were 131,201 and 271.In the test set (n=26 758)the identification effect was verified with the acquired S/F thresholds,which proved better than that of traditional regression model.Conclusion Noninvasive parameter SpO2/FiO2can replace PaO2/FiO2for the auxiliary diagnosis of ARDS in case the result of blood gas analysis is absent.