Risk stratification using SpO2/FiO2 and PEEP at initial ARDS diagnosis and after 24 h in patients with moderate or severe ARDS

Annals of Intensive Care
Luigi PisaniMARS consortium

Abstract

We assessed the potential of risk stratification of ARDS patients using SpO2/FiO2 and positive end-expiratory pressure (PEEP) at ARDS onset and after 24 h. We used data from a prospective observational study in patients admitted to a mixed medical-surgical intensive care unit of a university hospital in the Netherlands. Risk stratification was by cutoffs for SpO2/FiO2 and PEEP. The primary outcome was in-hospital mortality. Patients with moderate or severe ARDS with a length of stay of > 24 h were included in this study. Patients were assigned to four predefined risk groups: group I (SpO2/FiO2 ≥ 190 and PEEP < 10 cm H2O), group II (SpO2/FiO2 ≥ 190 and PEEP ≥ 10 cm), group III (SpO2/FiO2 < 190 and PEEP < 10 cm H2O) and group IV (SpO2/FiO2 < 190 and PEEP ≥ 10 cm H2O). The analysis included 456 patients. SpO2/FiO2 and PaO2/FiO2 had a strong relationship (P < 0.001, R 2 = 0.676) that could be described in a linear regression equation (SpO2/FiO2 = 42.6 + 1.0 * PaO2/FiO2). Risk stratification at initial ARDS diagnosis resulted in groups that had no differences in in-hospital mortality. Risk stratification at 24 h resulted in groups with increasing mortality rates. The association between group assignment at 24 h and outcome was confo...Continue Reading

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Citations

Jul 26, 2018·Current Opinion in Critical Care·Marija VukojaMarcus J Schultz
Sep 13, 2019·American Journal of Respiratory and Critical Care Medicine·Edward PalmerSteve Harris
Aug 29, 2020·Daru : Journal of Faculty of Pharmacy, Tehran University of Medical Sciences·Hamid RahmaniMir Saeed Yekaninejad
Dec 19, 2020·Intensive Care Medicine Experimental·David M P van MeenenUNKNOWN MARS Consortium
Oct 18, 2020·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Francisco Martín-RodríguezAntonio Dueñas-Laita

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