Clinical Characteristics and Outcomes Are Similar in ARDS Diagnosed by Oxygen Saturation/F io 2 Ratio Compared With Pao 2 /F io 2 Ratio

Cui, Wei; Janz, David R.; Shaver, Ciara M.; Bernard, Gordon R.; Bastarache, Julie A.; Ware, Lorraine B.

doi:10.1378/chest.15-0169

Cited by 134 publications

(126 citation statements)

References 33 publications

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“…It is also possible that differences in ventilator management strategies account for the difference in mortality. 29 Our study has limitations, most importantly the fact that the included ABG data were the result of routine clinical ABG testing, with the associated risk of …”

Section: Resultsmentioning

confidence: 97%

Nonlinear Imputation of Pao2/Fio2 From Spo2/Fio2 Among Patients With Acute Respiratory Distress Syndrome

Brown

Grissom

Moss

et al. 2016

CHEST

149

112

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with the NIH/NHLBI PETAL Network Collaborators BACKGROUND: ARDS is an important clinical problem. The definition of ARDS requires testing of arterial blood gas to define the ratio of PaO 2 to FIO 2 (PaO 2 /FIO 2 ratio). However, many patients with ARDS do not undergo blood gas measurement, which may result in underdiagnosis of the condition. As a consequence, a method for estimating PaO 2 on the basis of noninvasive measurements is desirable.

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Section: Resultsmentioning

confidence: 97%

Nonlinear Imputation of Pao2/Fio2 From Spo2/Fio2 Among Patients With Acute Respiratory Distress Syndrome

Brown

Grissom

Moss

et al. 2016

CHEST

149

112

View full text Add to dashboard Cite

show abstract

“…In these patients, the SpO 2 /FiO 2 ratio was used as a surrogate marker to diagnose hypoxemia. The SpO 2 /FiO 2 ratio is a noninvasive way to evaluate oxygenation and has been shown to have diagnostic utility in people, particularly in children with ARDS, in whom arterial blood sampling can be challenging . Preliminary evaluation of the SpO 2 /FiO 2 ratio in dogs found that this ratio correlated well with the PaO 2 /FiO 2 ratio in a population of dogs requiring assessment of oxygenation .…”

Section: Discussionmentioning

confidence: 99%

Retrospective evaluation of the prevalence, risk factors, management, outcome, and necropsy findings of acute lung injury and acute respiratory distress syndrome in dogs and cats: 29 cases (2011–2013)

Balakrishnan

Drobatz

Silverstein

2017

J Vet Emergen Crit Care

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“…Adult critically ill patients were included in VALID if they remained in the ICU for at least 2 days and were excluded if they had a history of severe chronic lung disease or were admitted for uncomplicated overdose [12, 13]. Informed consent was obtained for sample collection from the patients or their designated surrogates; if patients or surrogates were unable to provide consent, the institutional review board granted a waiver of consent.…”

Section: Methodsmentioning

confidence: 99%

Circulating microparticle levels are reduced in patients with ARDS

et al. 2017

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BackgroundIt is unclear how to identify which patients at risk for acute respiratory distress syndrome (ARDS) will develop this condition during critical illness. Elevated microparticle (MP) concentrations in the airspace during ARDS are associated with activation of coagulation and in vitro studies have demonstrated that MPs contribute to acute lung injury, but the significance of MPs in the circulation during ARDS has not been well studied. The goal of the present study was to test the hypothesis that elevated levels of circulating MPs could prospectively identify critically ill patients who will develop ARDS and that elevated circulating MPs are associated with poor clinical outcomes.MethodsA total of 280 patients with platelet-poor plasma samples from the prospective Validating Acute Lung Injury biomarkers for Diagnosis (VALID) cohort study were selected for this analysis. Demographics and clinical data were obtained by chart review. MP concentrations in plasma were measured at study enrollment on intensive care unit (ICU) day 2 and on ICU day 4 by MP capture assay. Activation of coagulation was measured by plasma recalcification (clot) times.ResultsARDS developed in 90 of 280 patients (32%) in the study. Elevated plasma MP concentrations were associated with reduced risk of developing ARDS (odds ratio (OR) 0.70 per 10 μM increase in MP concentration, 95% CI 0.50–0.98, p = 0.042), but had no significant effect on hospital mortality. MP concentration was greatest in patients with sepsis, pneumonia, or aspiration as compared with those with trauma or receiving multiple blood transfusions. MP levels did not significantly change over time. The inverse association of MP levels with ARDS development was most striking in patients with sepsis. After controlling for age, presence of sepsis, and severity of illness, higher MP concentrations were independently associated with a reduced risk of developing ARDS (OR 0.69, 95% CI 0.49–0.98, p = 0.038). MP concentration was associated with reduced plasma recalcification time.ConclusionsElevated levels of circulating MPs are independently associated with a reduced risk of ARDS in critically ill patients. Whether this is due to MP effects on systemic coagulation warrants further investigation.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-017-1700-7) contains supplementary material, which is available to authorized users.

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Clinical Characteristics and Outcomes Are Similar in ARDS Diagnosed by Oxygen Saturation/F io 2 Ratio Compared With Pao 2 /F io 2 Ratio

Cited by 134 publications

References 33 publications

Nonlinear Imputation of Pao2/Fio2 From Spo2/Fio2 Among Patients With Acute Respiratory Distress Syndrome

Nonlinear Imputation of Pao2/Fio2 From Spo2/Fio2 Among Patients With Acute Respiratory Distress Syndrome

Retrospective evaluation of the prevalence, risk factors, management, outcome, and necropsy findings of acute lung injury and acute respiratory distress syndrome in dogs and cats: 29 cases (2011–2013)

Circulating microparticle levels are reduced in patients with ARDS

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