The use of the pulse oximetric saturation to fraction of inspired oxygen ratio in an automated acute respiratory distress syndrome screening tool

External Validity of Electronic Sniffers for Automated Recognition of Acute Respiratory Distress Syndrome

“…We also used Sp o 2 –Fi o 2 data when arterial blood gas data were not available. As previously demonstrated, Sp o 2 –Fi o 2 criteria for ARDS are a reasonable extension and have been shown to provide similar findings 17 as well as identify patients with similar clinical outcomes. 21 Use of the Sp o 2 /Fio 2 allows for deployment of the algorithm in a population where arterial blood gases are not frequently obtained; however, it is conceivable that adding Sp o 2 /Fi o 2 criteria to the sniffers may have reduced specificity of the sniffers compared to prior sniffers.…”

“…16 Schmidt et al demonstrated strong agreement in the Herasevich algorithm when employing Pa o 2 –Fi o 2 or Sp o 2 –Fi o 2 ratios. 17 The initial Herasevich screen used a positive chest radiograph report and a Pa o 2 –Fi o 2 ratio of <300 within 24 hours of each other as a positive screen for ALI. We altered this slightly by flagging patients as possible ARDS by Herasevich criteria if during a clinical day (morning to morning) in the VALID cohort, a radiographic report met the Boolean criteria and the lowest Sp o 2 –Fi o 2 ratio or Pa o 2 –Fi o 2 ratio of the same day was ≤315 or 300, respectively.…”

Biomarkers of acute respiratory distress syndrome in adults hospitalised for severe SARS-CoV-2 infection in Tenerife Island, Spain

“…Several studies have shown that SARS-CoV-2 infected patients with an unfavourable, clinical course have higher levels of interleukin-6 and ferritin than subjects with a milder course [9,10]. Thus, both biomarkers were proposed for COVID-19 patient monitoring during hospitalisation [11]. As to d-dimers, ARDS is known to associate with a hyper-coagulable state [37].…”

“…The following variables were collected at hospital admission: (1) the demographic data age, sex, and smoking habit (active smokers if they had smoked at least one cigarette in the last 6 months, former smokers if they had smoked in the past but were remaining abstinent for at least 6 months, or non-smokers if they had never smoked); (2) the comorbidities arterial hypertension (AHT), dyslipidaemia (DLP), type 2 diabetes mellitus (T2DM), chronic obstructive pulmonary disease (COPD), asthma, ischaemic heart disease, atrial fibrillation, previous neoplasia, chronic kidney disease, and liver disease (the Charlson comorbidity index was calculated individually) [13]; (3) symptoms and findings from physical examination; (4) time lag between symptom onset and hospital admission; (5) total number of leukocytes, lymphocytes, and platelets, d-dimers, LDH, creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), C-reactive protein (CRP), sodium (Na), and potassium (K); (6) severity of the disease at admission by calculating the CURB65 score (confusion, urea, respiratory rate, blood pressure, age; range 0-5) [14] and the SpO2/FiO2 ratio [11]. An SpO2/FiO2 ratio < 235 was considered indicative for ARDS, which corresponds to a PaO2/FiO2 ratio (ratio of partial pressure of arterial oxygen in mmHg to the fraction of inspired oxygen) < 200 (moderate to severe ARDS) [15].…”

“…In addition, serum biomarkers, such as leukocyte and lymphocyte counts, lactate dehydrogenase (LDH), d-dimer, troponin I, and ferritin levels seem to indicate the severity of the process and hence the need for ICU admission or may even predict mortality [6][7][8][9][10]. The pulse oximetric oxygen saturation/fraction of inspired oxygen (SpO2/ FiO2) ratio is a simple measure, conventionally used in the context of ARDS [11]. Moreover, it seems to identify Figueira Gonçalves et al BMC Res Notes (2020) 13:555 severely SARS-COV-2 infected patients who are at a high risk of death [12].…”