Prognostication using SpO(2)/FiO(2) in invasively ventilated ICU patients with ARDS due to COVID-19-Insights from the PRoVENT-COVID study

PRoVENT-COVID Collaborative Grp, Jan-Paul Roozeman*, Guido Mazzinari, A. Serpa Neto, M. W. Hollmann, F. Paulus, Marcus J. Schultz, Luigi Pisani, A. G. Algera, L. S. Boers, L. D. J. Bos, M. Botta, D. A. Dongelmans, M. W. Hollmann, J. Horn, F. Paulus, J. Pillay, M. J. Schultz, A. Serpa Neto, A. M. TsonasA. P. J. Vlaar, S. Ahuja, J. P. van Akkeren, C. K. Algoe, R. B. van Amstel, A. Artigas, O. L. Baur, P. van de Berg, A. E. van den Berg, M. M. de Boer, J. S. Breel, H. de Bruin, S. de Bruin, W. Dieperink, M. J. de Graaff, S. T. van der Heide, N. F. L. Heijnen, M. E. Hoogendoorn, R. van der Horst, D. Ivanov, E. Kho, M. Koopmans, M. A. Kuiper, D. W. de Lange, M. Onrust, M. R. Smit, P. E. Spronk, P. van Vliet, P. H. J. van der Voort, B. van Wijk, A. R. H. van Zanten

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

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Samenvatting

Background: The SpO(2)/FiO(2) is a useful oxygenation parameter with prognostic capacity in patients with ARDS. We investigated the prognostic capacity of SpO(2)/FiO(2) for mortality in patients with ARDS due to COVID-19.

Methods: This was a post-hoc analysis of a national multicenter cohort study in invasively ventilated patients with ARDS due to COVID-19. The primary endpoint was 28-day mortality.

Results: In 869 invasively ventilated patients, 28-day mortality was 30.1%. The SpO(2)/FiO(2) on day 1 had no prognostic value. The SpO(2)/FiO(2) on day 2 and day 3 had prognostic capacity for death, with the best cut-offs being 179 and 199, respectively. Both SpO(2)/FiO(2) on day 2 (OR, 0.66 [95%-CI 0.46-0.96]) and on day 3 (OR, 0.70 [95%-CI 0.51-0.96]) were associated with 28-day mortality in a model corrected for age, pH, lactate levels and kidney dysfunction (AUROC 0.78 [0.76-0.79]). The measured PaO2/FiO(2) and the PaO2/FiO(2) calculated from SpO(2)/FiO(2) were strongly correlated (Spearman's r = 0.79).

Conclusions: In this cohort of patients with ARDS due to COVID-19, the SpO(2)/FiO(2) on day 2 and day 3 are independently associated with and have prognostic capacity for 28-day mortality. The SpO(2)/FiO(2) is a useful metric for risk stratification in invasively ventilated COVID-19 patients. (C) 2021 The Authors. Published by Elsevier Inc.

Originele taal-2English
Pagina's (van-tot)31-37
Aantal pagina's7
TijdschriftJournal of Critical Care
Volume68
DOI's
StatusPublished - apr-2022

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