TY - JOUR
T1 - Prognostication using SpO2/FiO2 in invasively ventilated ICU patients with ARDS due to COVID-19 - Insights from the PRoVENT-COVID study
AU - Roozeman, Jan-Paul
AU - Mazzinari, Guido
AU - Serpa Neto, Ary
AU - Hollmann, Markus W
AU - Paulus, Frederique
AU - Schultz, Marcus J
AU - Pisani, Luigi
AU - Cremer, Olaf
AU - de Lange, Prof.dr. D.W. (Dylan)
N1 - Funding Information:
None.
Publisher Copyright:
© 2021 The Authors
PY - 2022/4
Y1 - 2022/4
N2 - 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.
AB - 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.
KW - COVID-19/complications
KW - Cohort Studies
KW - Humans
KW - Intensive Care Units
KW - Oximetry
KW - Respiratory Distress Syndrome/therapy
KW - Acute respiratory distress syndrome
KW - COVID-19
KW - SpO /FiO
KW - Pulse oximetry
KW - Resource limited settings
KW - Mechanical ventilation
UR - http://www.scopus.com/inward/record.url?scp=85126317579&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2021.11.009
DO - 10.1016/j.jcrc.2021.11.009
M3 - Article
C2 - 34872014
SN - 0883-9441
VL - 68
SP - 31
EP - 37
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -