Correlation and validity of imputed PaO2/FiO2 and SpO2/FiO2 in patients with invasive mechanical ventilation at 2600 m above sea level

Ortiz, Guillermo; Bastidas, Alírio Rodrigo; Garay-Fernández, Manuel; Lara, Andrea; Benavides, Manuel; Rocha, Eduardo; Buitrago, Andrés F.; Díaz, Gerardo Borroto; Ordóñez, J.; Reyes, Luis Felipe

doi:10.1016/j.medin.2021.05.001

Cited by 9 publications

(6 citation statements)

References 25 publications

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“…Al remplazar en el puntaje SCAP el parámetro PaO2/FiO2 <250 o PaO2 <54 mmHg por SpO2/FiO2 <400, se mantiene el redimiento de este puntaje para la predicción de los diferentes desenlaces estudiados; incluso, sigue siendo mejor que el CURB-65 en nuestra población. La SpO2/FiO2 como variable del estado de oxigenación y como factor para mortalidad en el paciente con compromiso pulmonar ha sido estudiado en diferentes poblaciones 28,29,30 , Fukuda et al, en una cohorte de 572 pacientes con NAC severa encontró que la SpO2/FiO2 era un predictor de mortalidad intrahospitalaria así como de VMi, los valores bajos de esta relación se asociaron a pacientes que requirieron intubación orotraqueal temprana y los valores altos a pacientes que sobrevivieron 28 ; además, constituye una herramienta no-invasiva, rápidamente disponible y que facilitaria el cálculo del puntaje SCAP al no requerir la obtención de muestras de sangre arterial ni equipos de analisis de gases arteriales 26 .…”

Section: Discussionunclassified

Rendimiento de la escala Severe Community Acquired Pneumonia (SCAP) para la predicción de desenlaces clínicos en neumonía

Reyes-Velasco

Goyes

Leguízamo-Isaza

et al. 2022

Infect

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Objetivo: evaluar el desempeño de la escala Severe Community Acquired Pneumonia (SCAP) en pacientes con neumonía adquirida en la comunidad (NAC) para la predicción de muerte intrahospitalaria, a 30 días, requerimiento de ventilación mecánica invasiva (VMi) y de soporte vasopresor. Metodología: estudio de cohorte retrospectivo con análisis de prueba diagnóstica de la escala SCAP en pacientes con NAC conforme a los criterios de la American Thoracic Society (ATS) y la Infectious Diseases Society of America (IDSA). Se estimó una escala SCAP adicional reemplazando la PaO2/FiO2<250 por la SpO2/ FiO2<400. Se calcularon los OR crudos y ajustados por cada variable de los puntajes con los desenlaces de interés, así como las áreas bajo la curva de la característica operativa del receptor (ACOR). Se compararon las ACOR con la prueba De-Long, considerando una p<0,05 estadísticamente significativa. Resultados: se incluyeron 1795 pacientes en el análisis definitivo, 13,6% fallecieron en el hospital y 15% en el seguimiento a 30 días, 10,8% requirieron VMi y 11,4% soporte vasopresor. La sensibilidad de la escala SCAP para la predicción de los cuatro desenlaces previamente mencionados fue mayor que la del puntaje CURB-65. El rendimiento de la escala no se modifica al emplear como criterio la SpO2/FiO2<400. Conclusiones: la escala SCAP presenta un buen desempeño para la predicción de los desenlaces clínicos en neumonía, manteniendo su rendimiento cuando se utiliza la SpO2/FiO2<400.

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Section: Discussionunclassified

Rendimiento de la escala Severe Community Acquired Pneumonia (SCAP) para la predicción de desenlaces clínicos en neumonía

Reyes-Velasco

Goyes

Leguízamo-Isaza

et al. 2022

Infect

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“…Respiratory rate is an endpoint that is simple to determine and provides relevant feedback, constituting one of the first incipient signs of shock, being tachypnea a powerful warning predictor of shock 20 . Likewise, the reported clinical usefulness of SaFi has been verified in several clinical scenarios, 16,21–23 where the correlation between SaFi and the partial pressure of oxygen in arterial blood/fraction of inspired oxygen ratio is well‐understood 24–26 . Lastly, GCS has conventionally served as one of the criteria for IRS (scores less than or equal to 8 points with the motor component of the GCS altered) in mayor trauma, specifically in traumatic brain injury 27,28 .…”

Section: Discussionmentioning

confidence: 99%

“…20 Likewise, the reported clinical usefulness of SaFi has been verified in several 16,[21][22][23] where the correlation between SaFi and the partial pressure of oxygen in arterial blood/ fraction of inspired oxygen ratio is well-understood. [24][25][26] Lastly, GCS has conventionally served as one of the criteria for IRS (scores less than or equal to 8 points with the motor component of the GCS altered) in mayor trauma, specifically in traumatic brain injury. 27,28 The mGCS is a strong indicator of primary motor cortex performance in general, not only in neurocritical patients.…”

Section: Discussionmentioning

confidence: 99%

Prehospital Respiratory Early Warning Score for airway management in‐ambulance: A score comparison

Martin-Rodríguez

López-Izquierdo

Sanz-García

et al. 2022

Eur J Clin Investigation

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Background Prehospital Respiratory Early Warning Scores to estimate the requirement for advanced respiratory support is needed. To develop a prehospital Respiratory Early Warning Score to estimate the requirement for advanced respiratory support. Methods Multicentre, prospective, emergency medical services (EMS)‐delivered, longitudinal cohort derivationvalidation study carried out in 59 ambulances and five hospitals across five Spanish provinces. Adults with acute diseases evaluated, supported and discharged to the Emergency Department with high priority were eligible. The primary outcome was the need for invasive or non‐invasive respiratory support (NIRS or IRS) in the prehospital scope at the first contact with the patient. The measures included the following: epidemiological endpoints, prehospital vital signs (respiratory rate, pulse oximetry saturation, fraction of inspired oxygen, systolic and diastolic mean blood pressure, heart rate, tympanic temperature and consciousness level by the GCS). Results Between 26 Oct 2018 and 26 Oct 2021, we enrolled 5793 cases. For NIRS prediction, the final model of the logistic regression included respiratory rate and pulse oximetry saturation/fraction of inspired oxygen ratio. For the IRS case, the motor response from the Glasgow Coma Scale was also included. The REWS showed an AUC of 0.938 (95% CI: 0.918–0.958), a calibration‐in‐large of 0.026 and a higher net benefit as compared with the other scores. Conclusions Our results showed that REWS is a remarkably aid for the decision‐making process in the management of advanced respiratory support in prehospital care. Including this score in the prehospital scenario could improve patients' care and optimise the resources' management.

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“…The initial derivation and validation of the linear imputation of the PaO 2 /FiO 2 ratio from the SpO 2 /FiO 2 ratio excluded patients with SpO 2 values of more than 97% and those at more than 1000 m above sea level. 8 The validity of imputing the PaO 2 /FiO 2 ratio at higher altitudes using linear, log-linear, or non-linear formulas outside their original derivation and validation cohorts has been demonstrated in at least one study, 93 but applying the linear imputation of the PaO 2 /FiO 2 ratio from the SpO 2 /FiO 2 ratio to these populations probably requires further validation. The log-linear imputation of the PaO 2 /FiO 2 ratio from the SpO 2 /FiO 2 ratio included patients both with and without hypoxaemic respiratory failure, with SpO 2 values of up to 98% and PaO 2 /FiO 2 ratios of more than 300 mm Hg included in the derivation population.…”

Section: Generalisability Of Pulse Oximetry-based Indicesmentioning

confidence: 99%

Pulse oximetry for the diagnosis and management of acute respiratory distress syndrome

Wick¹,

Matthay²,

Ware³

2022

The Lancet Respiratory Medicine

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Correlation and validity of imputed PaO2/FiO2 and SpO2/FiO2 in patients with invasive mechanical ventilation at 2600 m above sea level

Cited by 9 publications

References 25 publications

Rendimiento de la escala Severe Community Acquired Pneumonia (SCAP) para la predicción de desenlaces clínicos en neumonía

Rendimiento de la escala Severe Community Acquired Pneumonia (SCAP) para la predicción de desenlaces clínicos en neumonía

Prehospital Respiratory Early Warning Score for airway management in‐ambulance: A score comparison

Pulse oximetry for the diagnosis and management of acute respiratory distress syndrome

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