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

PeerJ

article

Miguel Hueda-Zavaleta¹  Cesar Copaja-Corzo¹  Brayan Miranda-Chávez¹  Rodrigo Flores-Palacios²  Jonathan Huanacuni-Ramos²  Juan Mendoza-Laredo¹  Diana Minchón-Vizconde¹  Juan Carlos Gómez de la Torre⁵  Vicente A. Benites-Zapata⁶ 

[1] Facultad de Ciencias de la Salud, Universidad Privada de Tacna;Hospital III Daniel Alcides Carrión—EsSalud;Red Asistencial Ucayali EsSalud;Hospital Hipólito Unanue de Tacna;Laboratorio Clínico Roe;Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola

关键词: COVID-19;    SARS-CoV-2;    Respiratory distress syndrome;    Mortality;    Hospital mortality;    Critical care;    Peru;   

DOI  :  10.7717/peerj.14290

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

IntroductionAcute 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.MethodsA 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).ResultsTwo 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.ConclusionPaO2/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.

【 授权许可】

CC BY