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Assessment of the SpO2/FiO2 ratio as a tool for hypoxemia screening in the emergency department.
Catoire, Pierre; Tellier, Eric; de la Rivière, Caroline; Beauvieux, Marie-Christine; Valdenaire, Guillaume; Galinski, Michel; Revel, Philippe; Combes, Xavier; Gil-Jardiné, Cédric.
  • Catoire P; Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France. Electronic address: pierre.catoire@chu-bordeaux.fr.
  • Tellier E; Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France; INSERM, ISPED, Bordeaux Population Health research center INSERM U1219-"Injury Epidemiology Transport Occupation" team, Université de Bordeaux, 146 Rue Léo Saignat, Bordeaux 33000, Franc
  • de la Rivière C; Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France.
  • Beauvieux MC; University Hospital of Bordeaux, Biochemistry Department, Université de Bordeaux, 146 Rue Léo Saignat, Bordeaux 33000, France; Center for Magnetic Resonance of Biological Systems, UMR5536, Université de Bordeaux, 146 Rue Léo Saignat, Bordeaux 33000, France.
  • Valdenaire G; Clinique Mutualiste, Emergency Medicine Department, 46 Avenue du Dr Albert Schweitzer, Pessac 33600, France.
  • Galinski M; Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France; INSERM, ISPED, Bordeaux Population Health research center INSERM U1219-"Injury Epidemiology Transport Occupation" team, Université de Bordeaux, 146 Rue Léo Saignat, Bordeaux 33000, Franc
  • Revel P; Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France; INSERM, ISPED, Bordeaux Population Health research center INSERM U1219-"Injury Epidemiology Transport Occupation" team, Université de Bordeaux, 146 Rue Léo Saignat, Bordeaux 33000, Franc
  • Combes X; Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France; INSERM, ISPED, Bordeaux Population Health research center INSERM U1219-"Injury Epidemiology Transport Occupation" team, Université de Bordeaux, 146 Rue Léo Saignat, Bordeaux 33000, Franc
  • Gil-Jardiné C; Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France; INSERM, ISPED, Bordeaux Population Health research center INSERM U1219-"Injury Epidemiology Transport Occupation" team, Université de Bordeaux, 146 Rue Léo Saignat, Bordeaux 33000, Franc
Am J Emerg Med ; 44: 116-120, 2021 06.
Article in English | MEDLINE | ID: covidwho-1245820
ABSTRACT

OBJECTIVE:

We assessed the performance of the ratio of peripheral arterial oxygen saturation to the inspired fraction of oxygen (SpO2/FiO2) to predict the ratio of partial pressure arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) among patients admitted to our emergency department (ED) during the SARS-CoV-2 outbreak.

METHODS:

We retrospectively studied patients admitted to an academic-level ED in France who were undergoing a joint measurement of SpO2 and arterial blood gas. We compared SpO2 with SaO2 and evaluated performance of the SpO2/FiO2 ratio for the prediction of 300 and 400 mmHg PaO2/FiO2 cut-off values in COVID-19 positive and negative subgroups using receiver-operating characteristic (ROC) curves.

RESULTS:

During the study period from February to April 2020, a total of 430 arterial samples were analyzed and collected from 395 patients. The area under the ROC curves of the SpO2/FiO2 ratio was 0.918 (CI 95% 0.885-0.950) and 0.901 (CI 95% 0.872-0.930) for PaO2/FiO2 thresholds of 300 and 400 mmHg, respectively. The positive predictive value (PPV) of an SpO2/FiO2 threshold of 350 for PaO2/FiO2 inferior to 300 mmHg was 0.88 (CI95% 0.84-0.91), whereas the negative predictive value (NPV) of the SpO2/FiO2 threshold of 470 for PaO2/FiO2 inferior to 400 mmHg was 0.89 (CI95% 0.75-0.96). No significant differences were found between the subgroups.

CONCLUSIONS:

The SpO2/FiO2 ratio may be a reliable tool for hypoxemia screening among patients admitted to the ED, particularly during the SARS-CoV-2 outbreak.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Oxygen / COVID-19 / Hypoxia Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Am J Emerg Med Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Oxygen / COVID-19 / Hypoxia Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Am J Emerg Med Year: 2021 Document Type: Article