Prognostication using SpO 2 /FiO 2 in invasively ventilated ICU patients with ARDS due to COVID-19 - Insights from the PRoVENT-COVID study.

Autor: 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 Hospital, Acquaviva delle Fonti, Italy.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2022 Apr; Vol. 68, pp. 31-37. Date of Electronic Publication: 2021 Dec 03.
DOI: 10.1016/j.jcrc.2021.11.009
Abstrakt: 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 PaO 2 /FiO 2 and the PaO 2 /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.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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