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2023, Number 1

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Med Crit 2023; 37 (1)

Oxygenation indices as prognostic marker in severe pneumonia due to SARS-CoV-2

Buelna GF, Peniche MKG, Sánchez DJS, Rodríguez PNI, Martínez AFR, Calyeca SMV

Language: Spanish
References: 22
Page: 26-30
PDF size: 195.54 Kb.


ABSTRACT

Introduction: oxygenation indices we assess the function of the respiratory system of oxygenation and ventilation. Objective: to determine the value of arterial gases as a prognostic factor for the outcome of patients with severe SARS-CoV-2 pneumonia. Material and methods: retrospective, longitudinal, descriptive, analytical study. We included patients > 18 years with a diagnosis of SARS-CoV-2 pneumonia between 1 June and 31 December 2020. Patients were classified according to outcome: survivor or non-survivor. Descriptive statistics and parametric and non-parametric tests were used according to the case, ROC (Receiver Operating Characteristic Curve) curves were constructed to determine the cut-off points of arterial gases with the best sensitivity and specificity and the area under the curve (AUC) for the fatal outcome was determined. Results: we included 175 patients, 70.3% corresponded to the male sex, the mean age was 56 years (interquartile range 45-64). The survivor group included 51 patients and the non-survivor group 124 patients. When analyzing arterial gases at the time of admission to the ICU, paO2/FiO2 of 100 mmHg and respiratory index (RI) > 2.4 with ABC 0.694 and 0.722 respectively. At 96 hours of admission, PaO2/FiO2 of 145 mmHg stands out, the RI > 3 and the DA-aO2 of 0.22 with ABC 0.846, 0.840 and 0.842 respectively. Conclusion: arterial blood gases measured at 96 hours of ICU admission are prognostic markers for fatal outcome in severe SARS-CoV-2 pneumonia.


REFERENCES

  1. Cristancho Gómez W. Fisiología respiratoria: lo esencial en la práctica clínica. 3ra edición. Bogotá, Colombia. Manual Moderno. 2012.

  2. West J. Fisiología pulmonar. 7a edición. Estados Unidos. Panamericana. 2002.

  3. Sánchez Diaz JS. Manual práctico acido base: líquidos y electrolitos. México. Zarpra. 2020.

  4. Pan C, Liu L, Feng Xie J, et al. Acute respiratory distress syndrome: challenge for diagnosis and therapy. Chin Med J. 2018;131(10):1220-1224.

  5. Fan E, Brodie D, Slutsky A. Acute respiratory distress syndrome advances in diagnosis and treatment. JAMA. 2018;319(7):698-710.

  6. Artigas A, Bernard GR, Carlet J, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;157:1332-1347.

  7. Umbrello H, Formenti P, Bolgiaghi L, et al. Current concepts of ARDS: a narrative review. Int J Mol Sci. 2016;18(1):64.

  8. Henderson WR, Chen L, Amato MB, et al. Fifty years of research in ARDS: respiratory mechanics in acute respiratory distress syndrome. Am J Respir Crit Care Med. 2017;196(7):822-833.

  9. Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307:2526-2533.

  10. Ware LB, Matthay MA. The acute respiratory distress syndrome. N Engl J Med. 2000;342:1334-1349.

  11. Villar J. What is the acute respiratory distress syndrome? Respir Care. 2011;56:1539-1545.

  12. Cane RD, Shapiro BA, Templin R, et al. Unreliability of oxygen tension-based indices in reflecting intrapulmonary shunting in critically ill patients. Crit Care Med. 1988;16:1243-1245.

  13. Román-Vistraín G, Muñoz-Ramírez CM, Márquez-González H, et al. Valoración respiratoria durante la guardia. Residente. 2015;10(2):63-68.

  14. Colín EV, Monares ZE, Sánchez CC, et al. Índices de oxigenación como factores pronósticos en el síndrome de insuficiencia respiratoria aguda. Rev Asoc Mex Med Crit y Ter Int. 2008;22(3):131-142.

  15. Coetzee A, Swanevelder J, van der Spuy G, Jansen J. Gas exchange indices--how valid are they? S Afr Med J. 1995;85(11 Suppl):1227-1232.

  16. Gowda MS, Klocke RA. Variability of indices of hypoxemia in adult respiratory distress syndrome. Crit Care Med. 1997;25(1):41-45.

  17. Sganga G, Siegel JH, Coleman B, et al. The physiologic meaning of the respiratory index in various types of critical illness. Crit Shock. 1985;17:179-193.

  18. Kathirgamanathan A, McCahon RA, Hardman JG. Indices of pulmonary oxygenation in pathological lung states: an investigation using high-fidelity, computational modelling. Br J Anaesth. 2009;103(2):291-297.

  19. Schultz MJ, van Zanten AR, de Smet AM, et al. Mechanical ventilation in acute respiratory distress syndrome (ARDS): lung protecting strategies for improved alveolar recruitment. Ned Tijdschr Geneeskd. 2003;147(8):327-331.

  20. Rawat M, Chandrasekharan PK, Williams A, et al. Oxygen saturation index and severity of hypoxic respiratory failure. Neonatology. 2015;107(3):161-166.

  21. DesPrez K, McNeil JB, Wang C, et al. Oxygenation saturation index predicts clinical outcomes in ARDS. Chest. 2017;152(6):1151-1158. Erratum in: Chest. 2018;153(3):768.

  22. Vadi S. Correlation of oxygen index, oxygen saturation index, and PaO2/FiO2 ratio in invasive mechanically ventilated adults. Indian J Crit Care Med. 2021;25(1):54-55.




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