tetano
Editor, Senior Moderator
PeerJ
. 2022 Dec 13;10:e14290.
doi: 10.7717/peerj.14290. eCollection 2022.
Determination of PaO2/FiO2 after 24 h of invasive mechanical ventilation and ΔPaO2/FiO2 at 24 h as predictors of survival in patients diagnosed with ARDS due to COVID-19
Miguel Hueda-Zavaleta[SUP] 1 2 [/SUP], Cesar Copaja-Corzo[SUP] 1 3 [/SUP], Brayan Miranda-Chávez[SUP] 1 [/SUP], Rodrigo Flores-Palacios[SUP] 2 [/SUP], Jonathan Huanacuni-Ramos[SUP] 2 [/SUP], Juan Mendoza-Laredo[SUP] 1 2 [/SUP], Diana Minchón-Vizconde[SUP] 1 4 [/SUP], Juan Carlos Gómez de la Torre[SUP] 5 [/SUP], Vicente A Benites-Zapata[SUP] 6 [/SUP]
Affiliations
Abstract
Introduction: Acute respiratory distress syndrome (ARDS) due to Coronavirus Disease 2019 (COVID-19) causes high mortality. The objective of this study is to determine whether the arterial pressure of oxygen/inspiratory fraction of oxygen (PaO2/FiO2) 24 h after invasive mechanical ventilation (IMV) and the difference between PaO2/FiO2 at 24 h after IMV and PaO2/FiO2 before admission to IMV (ΔPaO2/FiO2 24 h) are predictors of survival in patients with ARDS due to COVID-19.
Methods: A retrospective cohort study was conducted that included patients with ARDS due to COVID-19 in IMV admitted to the intensive care unit (ICU) of a hospital in southern Peru from April 2020 to April 2021. The ROC curves and the Youden index were used to establish the cut-off point for PaO2/FiO2 at 24 h of IMV and ΔPaO2/FiO2 at 24 h associated with mortality. The association with mortality was determined by Cox regression, calculating the crude (cHR) and adjusted (aHR) risk ratios, with their respective 95% confidence intervals (95% CI).
Results: Two hundred patients were analyzed. The average age was 54.29 years, 79% were men, and 25.5% (n = 51) died. The cut-off point calculated for PaO2/FiO2 24 h after IMV and ΔPaO2/FiO2 24 h was 222.5 and 109.5, respectively. Those participants with a value below the cut-off point of ΔPaO2/FiO2 24 h and PaO2/FiO2 24 h after IMV had higher mortality, aHR = 3.32 (CI 95% [1.82-6.07]) and aHR = 2.87 (CI 95% [1.48-5.57]) respectively.
Conclusion: PaO2/FiO2 24 h after IMV and ΔPaO2/FiO2 24 h in patients diagnosed with ARDS due to COVID-19 on IMV were associated with higher hospital mortality. These findings are helpful to identify those patients with a higher risk of dying on admission to the ICU.
Keywords: COVID-19; Critical care; Hospital mortality; Mortality; Peru; Respiratory distress syndrome; SARS-CoV-2.
. 2022 Dec 13;10:e14290.
doi: 10.7717/peerj.14290. eCollection 2022.
Determination of PaO2/FiO2 after 24 h of invasive mechanical ventilation and ΔPaO2/FiO2 at 24 h as predictors of survival in patients diagnosed with ARDS due to COVID-19
Miguel Hueda-Zavaleta[SUP] 1 2 [/SUP], Cesar Copaja-Corzo[SUP] 1 3 [/SUP], Brayan Miranda-Chávez[SUP] 1 [/SUP], Rodrigo Flores-Palacios[SUP] 2 [/SUP], Jonathan Huanacuni-Ramos[SUP] 2 [/SUP], Juan Mendoza-Laredo[SUP] 1 2 [/SUP], Diana Minchón-Vizconde[SUP] 1 4 [/SUP], Juan Carlos Gómez de la Torre[SUP] 5 [/SUP], Vicente A Benites-Zapata[SUP] 6 [/SUP]
Affiliations
- PMID: 36530414
- PMCID: PMC9756861
- DOI: 10.7717/peerj.14290
Abstract
Introduction: Acute respiratory distress syndrome (ARDS) due to Coronavirus Disease 2019 (COVID-19) causes high mortality. The objective of this study is to determine whether the arterial pressure of oxygen/inspiratory fraction of oxygen (PaO2/FiO2) 24 h after invasive mechanical ventilation (IMV) and the difference between PaO2/FiO2 at 24 h after IMV and PaO2/FiO2 before admission to IMV (ΔPaO2/FiO2 24 h) are predictors of survival in patients with ARDS due to COVID-19.
Methods: A retrospective cohort study was conducted that included patients with ARDS due to COVID-19 in IMV admitted to the intensive care unit (ICU) of a hospital in southern Peru from April 2020 to April 2021. The ROC curves and the Youden index were used to establish the cut-off point for PaO2/FiO2 at 24 h of IMV and ΔPaO2/FiO2 at 24 h associated with mortality. The association with mortality was determined by Cox regression, calculating the crude (cHR) and adjusted (aHR) risk ratios, with their respective 95% confidence intervals (95% CI).
Results: Two hundred patients were analyzed. The average age was 54.29 years, 79% were men, and 25.5% (n = 51) died. The cut-off point calculated for PaO2/FiO2 24 h after IMV and ΔPaO2/FiO2 24 h was 222.5 and 109.5, respectively. Those participants with a value below the cut-off point of ΔPaO2/FiO2 24 h and PaO2/FiO2 24 h after IMV had higher mortality, aHR = 3.32 (CI 95% [1.82-6.07]) and aHR = 2.87 (CI 95% [1.48-5.57]) respectively.
Conclusion: PaO2/FiO2 24 h after IMV and ΔPaO2/FiO2 24 h in patients diagnosed with ARDS due to COVID-19 on IMV were associated with higher hospital mortality. These findings are helpful to identify those patients with a higher risk of dying on admission to the ICU.
Keywords: COVID-19; Critical care; Hospital mortality; Mortality; Peru; Respiratory distress syndrome; SARS-CoV-2.