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

J.P. Roozeman; G. Mazzinari; A.S. Neto; M.W. Hollmann; F. Paulus; M.J. Schultz; L. Pisani; A.G. Algera; L.S. Boers; L.D.J. Bos; M. Botta; D.A. Dongelmans; J. Horn; J. Pillay; A.M. Tsonas; A.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; D.C.J.J. Bergmans; D.I. van den Bersselaar; F.A. Bertens; A.J.G.H. Bindels; M.M. de Boer; S. den Boer; M. Bogerd; J.S. Breel; H. de Bruin; S. de Bruin; C.L. Bruna; L.A. Buiteman-Kruizinga; O.L. Cremer; R.M. Determann; W. Dieperink; H.S. Franke; M.S. Galek-Aldridge; M.J. de Graaff; L.A. Hagens; J.J. Haringman; S.T. van der Heide; P.L.J. van der Heiden; N.F.L. Heijnen; PRoVENT-COVID Collaborative Group

doi:10.1016/j.jcrc.2021.11.009

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

J.P. Roozeman^*, G. Mazzinari, A.S. Neto, M.W. Hollmann, F. Paulus, M.J. Schultz, L. Pisani, A.G. Algera, L.S. Boers, L.D.J. Bos, M. Botta, D.A. Dongelmans, J. Horn, J. Pillay, A.M. Tsonas, A.P.J. Vlaar, S. Ahuja, J.P. van Akkeren, C.K. Algoe, R.B. van AmstelA. Artigas, O.L. Baur, P. van de Berg, A.E. van den Berg, D.C.J.J. Bergmans, D.I. van den Bersselaar, F.A. Bertens, A.J.G.H. Bindels, M.M. de Boer, S. den Boer, M. Bogerd, J.S. Breel, H. de Bruin, S. de Bruin, C.L. Bruna, L.A. Buiteman-Kruizinga, O.L. Cremer, R.M. Determann, W. Dieperink, H.S. Franke, M.S. Galek-Aldridge, M.J. de Graaff, L.A. Hagens, J.J. Haringman, S.T. van der Heide, P.L.J. van der Heiden, N.F.L. Heijnen, PRoVENT-COVID Collaborative Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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.

Original language	English
Pages (from-to)	31-37
Number of pages	7
Journal	Journal of Critical Care
Volume	68
DOIs	https://doi.org/10.1016/j.jcrc.2021.11.009
Publication status	Published - 1 Apr 2022

Keywords

COVID-19
Acute respiratory distress syndrome
SpO(2)/FiO(2)
Pulse oximetry
Mechanical ventilation
Resource limited settings
RESPIRATORY-DISTRESS-SYNDROME
RACIAL BIAS
RATIO
PAO2/FIO2

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10.1016/j.jcrc.2021.11.009Licence: CC BY

Cite this

Roozeman, J. P., Mazzinari, G., Neto, A. S., Hollmann, M. W., Paulus, F., Schultz, M. J., Pisani, L., Algera, A. G., Boers, L. S., Bos, L. D. J., Botta, M., Dongelmans, D. A., Horn, J., Pillay, J., Tsonas, A. M., Vlaar, A. P. J., Ahuja, S., van Akkeren, J. P., Algoe, C. K., ... PRoVENT-COVID Collaborative Group (2022). Prognostication using SpO(2)/FiO(2) in invasively ventilated ICU patients with ARDS due to COVID-19-Insights from the PRoVENT-COVID study. Journal of Critical Care, 68, 31-37. https://doi.org/10.1016/j.jcrc.2021.11.009

@article{79b4abdd193c4547953b91ba4fcbaef1,

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

abstract = "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.",

keywords = "COVID-19, Acute respiratory distress syndrome, SpO(2)/FiO(2), Pulse oximetry, Mechanical ventilation, Resource limited settings, RESPIRATORY-DISTRESS-SYNDROME, RACIAL BIAS, RATIO, PAO2/FIO2",

author = "J.P. Roozeman and G. Mazzinari and A.S. Neto and M.W. Hollmann and F. Paulus and M.J. Schultz and L. Pisani and A.G. Algera and L.S. Boers and L.D.J. Bos and M. Botta and D.A. Dongelmans and J. Horn and J. Pillay and A.M. Tsonas and A.P.J. Vlaar and S. Ahuja and {van Akkeren}, J.P. and C.K. Algoe and {van Amstel}, R.B. and A. Artigas and O.L. Baur and {van de Berg}, P. and {van den Berg}, A.E. and D.C.J.J. Bergmans and {van den Bersselaar}, D.I. and F.A. Bertens and A.J.G.H. Bindels and {de Boer}, M.M. and {den Boer}, S. and M. Bogerd and J.S. Breel and {de Bruin}, H. and {de Bruin}, S. and C.L. Bruna and L.A. Buiteman-Kruizinga and O.L. Cremer and R.M. Determann and W. Dieperink and H.S. Franke and M.S. Galek-Aldridge and {de Graaff}, M.J. and L.A. Hagens and J.J. Haringman and {van der Heide}, S.T. and {van der Heiden}, P.L.J. and N.F.L. Heijnen and {PRoVENT-COVID Collaborative Group}",

note = "Funding Information: None. Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2022",

month = apr,

day = "1",

doi = "10.1016/j.jcrc.2021.11.009",

language = "English",

volume = "68",

pages = "31--37",

journal = "Journal of Critical Care",

issn = "0883-9441",

publisher = "W B Saunders Co-Elsevier Inc",

}

Roozeman, JP, Mazzinari, G, Neto, AS, Hollmann, MW, Paulus, F, Schultz, MJ, Pisani, L, Algera, AG, Boers, LS, Bos, LDJ, Botta, M, Dongelmans, DA, Horn, J, Pillay, J, Tsonas, AM, Vlaar, APJ, Ahuja, S, van Akkeren, JP, Algoe, CK, van Amstel, RB, Artigas, A, Baur, OL, van de Berg, P, van den Berg, AE, Bergmans, DCJJ, van den Bersselaar, DI, Bertens, FA, Bindels, AJGH, de Boer, MM, den Boer, S, Bogerd, M, Breel, JS, de Bruin, H, de Bruin, S, Bruna, CL, Buiteman-Kruizinga, LA, Cremer, OL, Determann, RM, Dieperink, W, Franke, HS, Galek-Aldridge, MS, de Graaff, MJ, Hagens, LA, Haringman, JJ, van der Heide, ST, van der Heiden, PLJ, Heijnen, NFL & PRoVENT-COVID Collaborative Group 2022, 'Prognostication using SpO(2)/FiO(2) in invasively ventilated ICU patients with ARDS due to COVID-19-Insights from the PRoVENT-COVID study', Journal of Critical Care, vol. 68, pp. 31-37. https://doi.org/10.1016/j.jcrc.2021.11.009

TY - JOUR

T1 - Prognostication using SpO(2)/FiO(2) in invasively ventilated ICU patients with ARDS due to COVID-19-Insights from the PRoVENT-COVID study

AU - Roozeman, J.P.

AU - Mazzinari, G.

AU - Neto, A.S.

AU - Hollmann, M.W.

AU - Paulus, F.

AU - Schultz, M.J.

AU - Pisani, L.

AU - Algera, A.G.

AU - Boers, L.S.

AU - Bos, L.D.J.

AU - Botta, M.

AU - Dongelmans, D.A.

AU - Horn, J.

AU - Pillay, J.

AU - Tsonas, A.M.

AU - Vlaar, A.P.J.

AU - Ahuja, S.

AU - van Akkeren, J.P.

AU - Algoe, C.K.

AU - van Amstel, R.B.

AU - Artigas, A.

AU - Baur, O.L.

AU - van de Berg, P.

AU - van den Berg, A.E.

AU - Bergmans, D.C.J.J.

AU - van den Bersselaar, D.I.

AU - Bertens, F.A.

AU - Bindels, A.J.G.H.

AU - de Boer, M.M.

AU - den Boer, S.

AU - Bogerd, M.

AU - Breel, J.S.

AU - de Bruin, H.

AU - de Bruin, S.

AU - Bruna, C.L.

AU - Buiteman-Kruizinga, L.A.

AU - Cremer, O.L.

AU - Determann, R.M.

AU - Dieperink, W.

AU - Franke, H.S.

AU - Galek-Aldridge, M.S.

AU - de Graaff, M.J.

AU - Hagens, L.A.

AU - Haringman, J.J.

AU - van der Heide, S.T.

AU - van der Heiden, P.L.J.

AU - Heijnen, N.F.L.

AU - PRoVENT-COVID Collaborative Group

PY - 2022/4/1

Y1 - 2022/4/1

N2 - 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.

AB - 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.

KW - COVID-19

KW - Acute respiratory distress syndrome

KW - SpO(2)/FiO(2)

KW - Pulse oximetry

KW - Mechanical ventilation

KW - Resource limited settings

KW - RESPIRATORY-DISTRESS-SYNDROME

KW - RACIAL BIAS

KW - RATIO

KW - PAO2/FIO2

U2 - 10.1016/j.jcrc.2021.11.009

DO - 10.1016/j.jcrc.2021.11.009

M3 - Article

C2 - 34872014

SN - 0883-9441

VL - 68

SP - 31

EP - 37

JO - Journal of Critical Care

JF - Journal of Critical Care

ER -