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Prognostication using SpO2/FiO2 in invasively ventilated ICU patients with ARDS due to COVID-19 - Insights from the PRoVENT-COVID study.
Roozeman, Jan-Paul; Mazzinari, Guido; Serpa Neto, Ary; Hollmann, Markus W; Paulus, Frederique; Schultz, Marcus J; Pisani, Luigi.
  • Roozeman JP; Department of Intensive Care, Amsterdam UMC, Location 'AMC', Amsterdam, the Netherlands; Department of Anesthesiology, Amsterdam UMC, Location 'AMC', Amsterdam, the Netherlands. Electronic address: j.p.roozeman@amsterdamumc.nl.
  • Mazzinari G; Department of Anesthesiology, Hospital Universitario la Fe, Valencia, Spain; Perioperative Medicine Research Group, Instituto de Investigación Sanitaria Valencia, Spain.
  • Serpa Neto A; Department of Intensive Care, Amsterdam UMC, Location 'AMC', Amsterdam, the Netherlands; Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Hollmann MW; Department of Anesthesiology, Amsterdam UMC, Location 'AMC', Amsterdam, the Netherlands.
  • Paulus F; Department of Intensive Care, Amsterdam UMC, Location 'AMC', Amsterdam, the Netherlands.
  • Schultz MJ; Department of Intensive Care, Amsterdam UMC, Location 'AMC', Amsterdam, the Netherlands; Department of Anesthesiology, Amsterdam UMC, Location 'AMC', Amsterdam, the Netherlands; Mahidol-Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Pisani L; Department of Intensive Care, Amsterdam UMC, Location 'AMC', Amsterdam, the Netherlands; Anesthesia and Intensive Care Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy; Department of Anesthesiology and Intensive Care Medicine, Miulli Regional Hospita
J Crit Care ; 68: 31-37, 2022 04.
Article in English | MEDLINE | ID: covidwho-1556022
ABSTRACT

BACKGROUND:

The SpO2/FiO2 is a useful oxygenation parameter with prognostic capacity in patients with ARDS. We investigated the prognostic capacity of SpO2/FiO2 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 SpO2/FiO2 on day 1 had no prognostic value. The SpO2/FiO2 on day 2 and day 3 had prognostic capacity for death, with the best cut-offs being 179 and 199, respectively. Both SpO2/FiO2 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/FiO2 and the PaO2/FiO2 calculated from SpO2/FiO2 were strongly correlated (Spearman's r = 0.79).

CONCLUSIONS:

In this cohort of patients with ARDS due to COVID-19, the SpO2/FiO2 on day 2 and day 3 are independently associated with and have prognostic capacity for 28-day mortality. The SpO2/FiO2 is a useful metric for risk stratification in invasively ventilated COVID-19 patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: J Crit Care Journal subject: Critical Care Year: 2022 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Controlled clinical trial / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: J Crit Care Journal subject: Critical Care Year: 2022 Document Type: Article