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VOLUME 28 , ISSUE 3 ( March, 2024 ) > List of Articles

Original Article

A Prospective Observational Study Comparing Oxygen Saturation/Fraction of Inspired Oxygen Ratio with Partial Pressure of Oxygen in Arterial Blood/Fraction of Inspired Oxygen Ratio among Critically Ill Patients Requiring Different Modes of Oxygen Supplementation in Intensive Care Unit

T Rakesh Alur, Shivakumar S Iyer, Jignesh N Shah, Sampada Kulkarni, Prashant Jedge, Vishwanath Patil

Keywords : Acute hypoxemic respiratory failure, Berlin criteria, Kigali modification, Oxygen saturation/fraction of inspired oxygen ratio

Citation Information : Alur TR, Iyer SS, Shah JN, Kulkarni S, Jedge P, Patil V. A Prospective Observational Study Comparing Oxygen Saturation/Fraction of Inspired Oxygen Ratio with Partial Pressure of Oxygen in Arterial Blood/Fraction of Inspired Oxygen Ratio among Critically Ill Patients Requiring Different Modes of Oxygen Supplementation in Intensive Care Unit. Indian J Crit Care Med 2024; 28 (3):251-255.

DOI: 10.5005/jp-journals-10071-24652

License: CC BY-NC 4.0

Published Online: 29-02-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: Intensive care unit (ICU) patients face a significant rise in mortality rates due to acute hypoxemic respiratory failure (AHRF). The diagnosis of AHRF is based on the PF ratio, but it has limitations in resource-constrained settings. Instead, the Kigali modification suggests using the oxygen saturation/fraction of inspired oxygen (SF) ratio. This study aims to correlate SF ratio and arterial oxygen pressure (PF) ratio in critically ill adults with hypoxemic respiratory failure, who required O2 therapy through different modes of oxygen supplementation. Materials and methods: In an ICU, a prospective observational study included 125 adult AHRF patients receiving oxygen therapy, with data collected on FiO2, PaO2, and SpO2. The SF ratio and PF ratio were calculated, and their correlation was assessed using statistical analysis. The receiver operator characteristics (ROC) curve analysis was conducted to assess the diagnostic precision of the SF ratio in identifying AHRF. Results: Data from a total of 250 samples were collected. The study showed a positive correlation (r = 0.622) between the SF ratio and the PF ratio. The SF threshold values of 252 and 321 were established for PF values of 200 and 300, respectively, featuring a sensitivity of 69% and specificity of 95%. Furthermore, it is worth noting that the PF ratio and SF ratio are interchangeable, regardless of the type of oxygen therapy, as the median values of both the PF ratio and SF ratio displayed statistical significance (p < 0.01) in both acidosis and alkalosis conditions. Conclusion: For patients with AHRF, the noninvasive SF ratio can effectively serve as a substitute for the invasive PF ratio across all oxygen supplementation modes.


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  1. Isakow W. An approach to respiratory failure. In: Donnellan K, editor. The Washington Manual of Critical Care, 3rd edition. Philadelphia, Baltimore: Wolters Kluwer; 2018.
  2. Ware LB, Matthay MA. The acute respiratory distress syndrome. N Engl J Med 2000;342(18):1334–1349. DOI: 10.1056/NEJM200005043421806.
  3. Rubenfeld GD, Caldwell E, Peabody E, Weaver J, Martin DP, Neff M, et al. Incidence and outcomes of acute lung injury. N Engl J Med 2005;353(16):1685–1693. DOI: 10.1056/NEJMoa050333.
  4. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American–European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994;149(3 Pt 1):818–824. DOI: 10.1164/ajrccm.149.3.7509706.
  5. Matthay MA, Zemans RL, Zimmerman GA, Arabi YM, Beitler JR, Mercat A, et al. Acute respiratory distress syndrome. Nat Rev Dis Primers 2019;5(1):18. DOI: 10.1038/s41572-019-0069-0.
  6. Buregeya EFR, Talmor DS, Twagirumugabe T, Kiviri W, Riviello ED. Acute respiratory distress syndrome in the global context. Global Heart 2014;9(3):289–295. DOI: 10.1016/j.gheart.2014.08.003.
  7. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, et al. Acute respiratory distress syndrome: The Berlin Definition. JAMA 2012;307(23):2526–2533. DOI: 10.1001/jama.2012.5669.
  8. Angus DC. The acute respiratory distress syndrome: What's in a name? JAMA 2012;307(23):2542–2544. DOI: 10.1001/jama.2012.6761.
  9. Riviello ED, Kiviri W, Twagirumugabe T, Mueller A, Banner VM, Officer L, et al. Hospital incidence and outcomes of the acute respiratory distress syndrome using the Kigali modification of the Berlin definition. Am J Resp Crit Care Med 2016;193(1):52–59. DOI: 10.1164/rccm.201503-0584OC.
  10. Khemani RG, Patel NR, Bart RD III, Newth CJ. Comparison of the pulse oximetric saturation/fraction of inspired oxygen ratio and the PaO2/fraction of inspired oxygen ratio in children. Chest 2008;135(3):662–668. DOI: 10.1378/chest.08-2239.
  11. Laila DS, Yoel C, Hakimi H, Lubis M. Comparison of SpO2/FiO2 and PaO2/FiO2 ratios as markers of acute lung injury. Paediatr Indones 2017;57(1):30–34. DOI: 10.14238/pi57.1.2017.30-4.
  12. Babu S, Abhilash KPP, Kandasamy S, Gowri M. Association between SpO2/FiO2 ratio and PaO2/FiO2 ratio in different modes of oxygen supplementation. Indian J Crit Care Med 2021;25(9):1001–1005. DOI: 10.5005/jp-journals-10071-23977.
  13. Rice TW, Wheeler AP, Bernard GR, Hayden DL, Schoenfeld DA, Ware LB, et al. Comparison of the SpO2/FIO2 ratio and the PaO2/FIO2 ratio in patients with acute lung injury or ARDS. Chest 2007;132(2):410–417. DOI: 10.1378/chest.07-0617.
  14. Tripathi RS, Blum JM, Rosenberg AL, Tremper KK. Pulse oximetry saturation to fraction inspired oxygen ratio as a measure of hypoxia under general anesthesia and the influence of positive end-expiratory pressure. J Crit Care 2010;25:542.e9–542.e13. DOI: 10.1016/j.jcrc.2010.04.009.
  15. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39(2):175–191. DOI: 10.3758/bf03193146.
  16. Catoire P, Tellier E, Riviere C, Beauvieux MC, Valdenaire G, Galinski M, et al. Assessment of the SpO2/FiO2 ratio for hypoxemia screening in the emergency department. Am J Em Med 2021;44:116–120. DOI: 10.1016/j.ajem.2021.01.092.
  17. Pandharipande PP, Shintani AK, Hagerman HE, St Jacques PJ, Rice TW, Sanders NW, et al. 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(4):1317–1321. DOI: 10.1097/CCM.0b013e31819cefa9.
  18. Bilan N, Dastranji A, Behbahani AG. Comparison of the SpO2/FiO2 ratio and the PaO2/FiO2 ratio in patients with acute lung injury or acute respiratory distress syndrome. J CardiovascThorac Res 2015;7(1):28–31. DOI: 10.15171/jcvtr.2014.06.
  19. Liufu R, Wang C-Y, Weng L, Du B. Newly proposed diagnostic criteria for acute respiratory distress syndrome: Does inclusion of high flow nasal cannula solve the Problem? J Clin Med 2023;12(3):1043. DOI: 10.3390/jcm12031043.
  20. Vadi S. Correlation of oxygen index, oxygen saturation index, and PaO2/FiO2 ratio in invasive mechanically ventilated adults. Indian J Crit Care Med 2021;25(1):54–55. DOI: 10.5005/jp-journals-10071-23506.
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