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

Fecha de publicación: 01/04/2022 Fecha Ahead of Print: 03/12/2021

Autores de IIS La Fe

• Guido Mazzinari

  Autor

Participantes ajenos a IIS La Fe

• Roozeman JP
• Serpa Neto A
• Hollmann MW
• Paulus F
• Schultz MJ
• Pisani L
• PRoVENT-COVID Collaborative Group

Grupos

• Medicina Perioperatoria, Anestesiología y Reanimación

  

  Leader

  Óscar Díaz Cambronero

Abstract

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.

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

Keywords

• Acute respiratory distress syndrome; COVID-19; Mechanical ventilation; Pulse oximetry; Resource limited settings; SpO(2)/FiO(2)