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J Anesth . Peripheral oxygen saturation to inspiratory oxygen fraction ratio-based identification of critically ill coronavirus disease patients for

tetano

Editor, Senior Moderator
J Anesth


. 2021 Aug 15.
doi: 10.1007/s00540-021-02986-w. Online ahead of print.
Peripheral oxygen saturation to inspiratory oxygen fraction ratio-based identification of critically ill coronavirus disease patients for early therapeutic interventions


Masaru Shimizu[SUP] 1 [/SUP], Satoru Hashimoto[SUP] 2 [/SUP]



Affiliations

Abstract

Background: Early identification of critically ill coronavirus disease (COVID-19) patients in clinical settings is crucial in reducing the mortality rate. Therefore, this study aimed to determine whether the saturation of peripheral oxygen (SpO[SUB]2[/SUB]) to fraction of inspiratory oxygen (FiO[SUB]2[/SUB]) ratio (SF ratio) at admission is useful for the early identification of severe COVID-19.
Methods: This single-center, retrospective, observational study conducted at the University Hospital, Kyoto, Japan, included 26 patients diagnosed with COVID-19 between January 24 and May 6, 2020. COVID-19 severity was classified into two groups based on the SF ratio: ≤ 235 (moderate to severe disease: low group) and > 235 (normal to mild disease: high group). The characteristics, laboratory data, and outcomes of the patients were examined retrospectively and compared between the groups.
Results: Of the 26 patients [median age 51.5 years, interquartile range 35.8-67.0], 6 were in the low group (23%) and 20 in the high group (77%). The low group had a higher respiratory rate than the high group (p < 0.05). Blood tests immediately after admission showed that the low group had significantly lower albumin (p < 0.01), and higher lactate dehydrogenase (p < 0.01), C-reactive protein (p < 0.01), and D-dimer (p < 0.01) levels than the high group. Moreover, all patients received antiviral agents; four received continuous renal replacement therapy and invasive positive pressure ventilation, one received extracorporeal membrane oxygenation, and two died in the low group.
Conclusion: SF ratio measurement at admission could assist clinicians in the early identification of severe COVID-19, which in turn can lead to early therapeutic interventions.

Keywords: COVID-19; Early identification; SF ratio; Severity; SpO2/FiO2.
 
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