publication . Article . 2017

Risk stratification using SpO2/FiO2 and PEEP at initial ARDS diagnosis and after 24 h in patients with moderate or severe ARDS

Pisani, Luigi; Roozeman, Jan-Paul; Simonis, Fabienne D.; Giangregorio, Antonio; van der Hoeven, Sophia M.; Schouten, Laura R.; Horn, Janneke; Neto, Ary Serpa; Festic, Emir; Dondorp, Arjen M.; ...
Open Access English
  • Published: 01 Oct 2017
  • Country: United Kingdom
Abstract
Background We assessed the potential of risk stratification of ARDS patients using SpO2/FiO2 and positive end-expiratory pressure (PEEP) at ARDS onset and after 24 h. Methods We used data from a prospective observational study in patients admitted to a mixed medical–surgical intensive care unit of a university hospital in the Netherlands. Risk stratification was by cutoffs for SpO2/FiO2 and PEEP. The primary outcome was in-hospital mortality. Patients with moderate or severe ARDS with a length of stay of > 24 h were included in this study. Patients were assigned to four predefined risk groups: group I (SpO2/FiO2 ≥ 190 and PEEP < 10 cm H2O), group II (SpO2/FiO2 ≥...
Subjects
Medical Subject Headings: respiratory tract diseasesrespiratory systemcirculatory and respiratory physiologytherapeuticsfungi
free text keywords: Acute respiratory distress syndrome (ARDS), Blood gas analysis, Classification, Mortality, Outcome, Positive end-expiratory pressure (PEEP), Pulse oximetry, Risk stratification, Critical Care and Intensive Care Medicine, Journal Article, Research, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9, no
43 references, page 1 of 3

Ranieri, VM, Rubenfeld, GD. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012; 307: 1

Hernu, R, Wallet, F, Thiollière, F. An attempt to validate the modification of the American-European consensus definition of acute lung injury/acute respiratory distress syndrome by the Berlin definition in a university hospital. Intensive Care Med. 2013; 39: 2161-2170 [OpenAIRE] [PubMed] [DOI]

Villar, J, Pérez-Méndez, L, López, J. An early PEEP/FIO trial identifies different degrees of lung injury in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2007; 176: 795-804 [OpenAIRE] [PubMed] [DOI]

Villar, J, Fernandez, RL, Ambros, A. A clinical classification of the acute respiratory distress syndrome for predicting outcome and guiding medical therapy*. Crit Care Med. 2015; 43: 346-353 [PubMed] [DOI]

Bos, LD, Cremer, OL, Ong, DSY. External validation confirms the legitimacy of a new clinical classification of ARDS for predicting outcome. Intensive Care Med. 2015; 41: 2004-2005 [PubMed] [DOI]

Rice, TW, Wheeler, AP, Bernard, GR. Comparison of the SpO/FIO ratio and the PaO/FIO ratio in patients with acute lung injury or ARDS. Chest. 2007; 132: 410-417 [OpenAIRE] [PubMed] [DOI]

Chen, W, Janz, DR, Shaver, CM. Clinical characteristics and outcomes are similar in ARDS diagnosed by oxygen saturation/FiO2 ratio compared with PaO2/FiO2 ratio. Chest J. 2015; 148: 1477 [OpenAIRE] [DOI]

Parvathaneni, K, Belani, S, Leung, D. Evaluating the performance of the pediatric acute lung injury consensus conference definition of acute respiratory distress syndrome. Pediatr Crit Care Med. 2017; 18: 17-25 [PubMed] [DOI]

Klouwenberg, PMCK, Ong, DSY, Bos, LDJ. Interobserver agreement of centers for disease control and prevention criteria for classifying infections in critically Ill patients*. Crit Care Med. 2013; 41: 2373-2378 [OpenAIRE] [PubMed] [DOI]

Bernard, GR, Artigas, A, Brigham, KL. Report of the American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination. Intensive Care Med. 1994; 20: 225-232 [OpenAIRE] [PubMed] [DOI]

Zimmerman, JE, Kramer, AA, McNair, DS, Malila, FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today’s critically ill patients. Crit Care Med. 2006; 34: 1297-1310 [PubMed] [DOI]

Gajic, O, Dabbagh, O, Park, PK. Early identification of patients at risk of acute lung injury: evaluation of lung injury prediction score in a multicenter cohort study. Am J Respir Crit Care Med. 2010

Quan, H, Li, B, Couris, CM. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011; 173: 676-682 [OpenAIRE] [PubMed] [DOI]

Khemani, RG, Patel, NR, Bart, RD, Newth, CJL. Comparison of the pulse oximetric saturation/fraction of inspired oxygen ratio and the PaO2/fraction of inspired oxygen ratio in children. Chest. 2009; 135: 662-668 [OpenAIRE] [PubMed] [DOI]

Pandharipande, PP, Shintani, AK, Hagerman, HE. Derivation and validation of SpO2/FiO2 ratio to impute for PaO2/FiO2 ratio in the respiratory component of the Sequential Organ Failure Assessment score. Crit Care Med. 2009; 37: 1317-1321 [OpenAIRE] [PubMed] [DOI]

43 references, page 1 of 3
Abstract
Background We assessed the potential of risk stratification of ARDS patients using SpO2/FiO2 and positive end-expiratory pressure (PEEP) at ARDS onset and after 24 h. Methods We used data from a prospective observational study in patients admitted to a mixed medical–surgical intensive care unit of a university hospital in the Netherlands. Risk stratification was by cutoffs for SpO2/FiO2 and PEEP. The primary outcome was in-hospital mortality. Patients with moderate or severe ARDS with a length of stay of > 24 h were included in this study. Patients were assigned to four predefined risk groups: group I (SpO2/FiO2 ≥ 190 and PEEP < 10 cm H2O), group II (SpO2/FiO2 ≥...
Subjects
Medical Subject Headings: respiratory tract diseasesrespiratory systemcirculatory and respiratory physiologytherapeuticsfungi
free text keywords: Acute respiratory distress syndrome (ARDS), Blood gas analysis, Classification, Mortality, Outcome, Positive end-expiratory pressure (PEEP), Pulse oximetry, Risk stratification, Critical Care and Intensive Care Medicine, Journal Article, Research, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9, no
43 references, page 1 of 3

Ranieri, VM, Rubenfeld, GD. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012; 307: 1

Hernu, R, Wallet, F, Thiollière, F. An attempt to validate the modification of the American-European consensus definition of acute lung injury/acute respiratory distress syndrome by the Berlin definition in a university hospital. Intensive Care Med. 2013; 39: 2161-2170 [OpenAIRE] [PubMed] [DOI]

Villar, J, Pérez-Méndez, L, López, J. An early PEEP/FIO trial identifies different degrees of lung injury in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2007; 176: 795-804 [OpenAIRE] [PubMed] [DOI]

Villar, J, Fernandez, RL, Ambros, A. A clinical classification of the acute respiratory distress syndrome for predicting outcome and guiding medical therapy*. Crit Care Med. 2015; 43: 346-353 [PubMed] [DOI]

Bos, LD, Cremer, OL, Ong, DSY. External validation confirms the legitimacy of a new clinical classification of ARDS for predicting outcome. Intensive Care Med. 2015; 41: 2004-2005 [PubMed] [DOI]

Rice, TW, Wheeler, AP, Bernard, GR. Comparison of the SpO/FIO ratio and the PaO/FIO ratio in patients with acute lung injury or ARDS. Chest. 2007; 132: 410-417 [OpenAIRE] [PubMed] [DOI]

Chen, W, Janz, DR, Shaver, CM. Clinical characteristics and outcomes are similar in ARDS diagnosed by oxygen saturation/FiO2 ratio compared with PaO2/FiO2 ratio. Chest J. 2015; 148: 1477 [OpenAIRE] [DOI]

Parvathaneni, K, Belani, S, Leung, D. Evaluating the performance of the pediatric acute lung injury consensus conference definition of acute respiratory distress syndrome. Pediatr Crit Care Med. 2017; 18: 17-25 [PubMed] [DOI]

Klouwenberg, PMCK, Ong, DSY, Bos, LDJ. Interobserver agreement of centers for disease control and prevention criteria for classifying infections in critically Ill patients*. Crit Care Med. 2013; 41: 2373-2378 [OpenAIRE] [PubMed] [DOI]

Bernard, GR, Artigas, A, Brigham, KL. Report of the American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination. Intensive Care Med. 1994; 20: 225-232 [OpenAIRE] [PubMed] [DOI]

Zimmerman, JE, Kramer, AA, McNair, DS, Malila, FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today’s critically ill patients. Crit Care Med. 2006; 34: 1297-1310 [PubMed] [DOI]

Gajic, O, Dabbagh, O, Park, PK. Early identification of patients at risk of acute lung injury: evaluation of lung injury prediction score in a multicenter cohort study. Am J Respir Crit Care Med. 2010

Quan, H, Li, B, Couris, CM. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011; 173: 676-682 [OpenAIRE] [PubMed] [DOI]

Khemani, RG, Patel, NR, Bart, RD, Newth, CJL. Comparison of the pulse oximetric saturation/fraction of inspired oxygen ratio and the PaO2/fraction of inspired oxygen ratio in children. Chest. 2009; 135: 662-668 [OpenAIRE] [PubMed] [DOI]

Pandharipande, PP, Shintani, AK, Hagerman, HE. Derivation and validation of SpO2/FiO2 ratio to impute for PaO2/FiO2 ratio in the respiratory component of the Sequential Organ Failure Assessment score. Crit Care Med. 2009; 37: 1317-1321 [OpenAIRE] [PubMed] [DOI]

43 references, page 1 of 3
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