We assessed the performance of the ratio of peripheral arterial oxygen saturation to the inspired fraction of oxygen (SpO 2 /FiO 2) to predict the ratio of partial pressure arterial oxygen to the fraction of inspired oxygen (PaO 2 /FiO 2) among patients admitted to our emergency department (ED) during the SARS-CoV-2 outbreak. Methods: We retrospectively studied patients admitted to an academic-level ED in France who were undergoing a joint measurement of SpO 2 and arterial blood gas. We compared SpO 2 with SaO 2 and evaluated performance of the SpO 2 /FiO 2 ratio for the prediction of 300 and 400 mmHg PaO 2 /FiO 2 cutoff values in COVID-19 positive and negative subgroups using receiver-operating characteristic (ROC) curves. Results: During the study period from February to April 2020, a total of 430 arterial samples were analyzed and collected from 395 patients. The area under the ROC curves of the SpO 2 /FiO 2 ratio was 0.918 (CI 95% 0.885-0.950) and 0.901 (CI 95% 0.872-0.930) for PaO 2 /FiO 2 thresholds of 300 and 400 mmHg, respectively. The positive predictive value (PPV) of an SpO 2 /FiO 2 threshold of 350 for PaO 2 /FiO 2 inferior to 300 mmHg was 0.88 (CI95% 0.84-0.91), whereas the negative predictive value (NPV) of the SpO 2 /FiO 2 threshold of 470 for PaO 2 /FiO 2 inferior to 400 mmHg was 0.89 (CI95% 0.75-0.96). No significant differences were found between the subgroups. Conclusions: The SpO 2 /FiO 2 ratio may be a reliable tool for hypoxemia screening among patients admitted to the ED, particularly during the SARS-CoV-2 outbreak.

BackgroundThe French Emergency Medicine Society, the French Intensive Care Society and the Pediatric Intensive Care and Emergency Medicine French-Speaking Group edited guidelines on severe asthma exacerbation (SAE) in adult and pediatric patients.ResultsThe guidelines were related to 5 areas: diagnosis, pharmacological treatment, oxygen therapy and ventilation, patients triage, specific considerations regarding pregnant women. The literature analysis and formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology. An extensive literature research was conducted based on publications indexed in PubMed™ and Cochrane™ databases. Of the 21 formalized guidelines, 4 had a high level of evidence (GRADE 1+/−) and 7 a low level of evidence (GRADE 2+/−). The GRADE method was inapplicable to 10 guidelines, which resulted in expert opinions. A strong agreement was reached for all guidelines.ConclusionThe conjunct work of 36 experts from 3 scientific societies resulted in 21 formalized recommendations to help improving the emergency and intensive care management of adult and pediatric patients with SAE.

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