Peak Pressures and PaO2/FiO2 Ratios Are Associated With Adverse Outcomes in Patients on Mechanical Ventilators

Whiting, Jeremy; Edriss, Hawa; Yang, Shengping; Nugent, Kenneth

doi:10.1016/j.amjms.2016.01.028

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…13 However, these pressure measurements do provide readily available information about outcomes and complications. [14][15][16] Routine ICU care can improve respiratory mechanics and potentially improve outcomes. These measures should include consistent elevation of the head of the bed and prevention of excessively positive fluid balances.…”

Section: Discussionmentioning

confidence: 99%

The Association Between the Mechanical Ventilator Pressures and Outcomes in a Cohort of Patients with Acute Respiratory Failure

Edriss¹,

Yang

Juarez

et al. 2020

Clin Med Insights Circ Respir Pulm Med

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Background: Pressures measured during mechanical ventilation provide important information about the respiratory system mechanics and can help predict outcomes. Methods: The electronic medical records of patients hospitalized between 2010 and 2016 with sepsis who required mechanical ventilation were reviewed to collect demographic information, clinical information, management requirements, and outcomes, such as mortality, ICU length of stay, and hospital length of stay. Mechanical ventilation pressures were recorded on the second full day of hospitalization. Results: This study included 312 adult patients. The mean age is 59.1 ± 16.3 years; 57.4% were men. The mean BMI was 29.3 ± 10.7. Some patients had pulmonary infections (46.2%), and some patients had extrapulmonary infections (34.9%). The overall mortality was 42.6%. In a multi-variable model that included age, gender, number of comorbidities, APACHE 2 score, and PaO2/FiO2 ratio, peak pressure, plateau pressure, driving pressure, and PEEP all predicted mortality when entered into the model separately. There was an increase in peak pressure, plateau pressure, and driving pressure across BMI categories ranging from underweight to obese. Conclusions: This study demonstrates that ventilator pressure measurements made early during the management of patients with acute respiratory failure requiring mechanical ventilation provide prognostic information regarding outcomes, including mortality. Patients with high mechanical ventilator pressures during the early course of their acute respiratory failure require more attention to identify reversible disease processes when possible. In addition, increased BMIs are associated with increased ventilator pressures, and this increases the complexity of the clinical evaluation in the management of obese patients.

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Section: Discussionmentioning

confidence: 99%

The Association Between the Mechanical Ventilator Pressures and Outcomes in a Cohort of Patients with Acute Respiratory Failure

Edriss¹,

Yang

Juarez

et al. 2020

Clin Med Insights Circ Respir Pulm Med

Self Cite

View full text Add to dashboard Cite

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“…Arterial blood gas (ABG) test is considered the gold standard for the diagnosis of respiratory failure; however, especially in medical wards, such test is not always feasible and available. The ABG test allows the assessment of the ratio between arterial partial pressure of oxygen (PaO2, expressed in mmHg) and fractional inspired oxygen concentration (FiO2) (PaO2/FiO2 ratio), which is a validated index of hypoxaemia and is associated with adverse outcomes in patients with respiratory failure [9,10]. The PaO2/ FiO2 ratio is widely used in clinical practice especially for the diagnosis of ARDS according to the Berlin definition [11].…”

Section: Introductionmentioning

confidence: 99%

Performance of non-invasive respiratory function indices in predicting clinical outcomes in patients hospitalized for COVID-19 pneumonia in medical and sub-intensive wards: a retrospective cohort study

et al. 2022

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Coronavirus disease 2019 (COVID-19) is a newly recognized infectious disease which can lead to acute respiratory distress syndrome requiring ventilatory support and intensive care unit admission. The aim of our study is to evaluate the performance of two non-invasive respiratory function indices (the ROX index and the SatO2/FiO2 ratio), as compared to the traditional PaO2/FiO2 ratio, in predicting a clinically relevant composite outcome (death or intubation) in hospitalized patients for COVID-19 pneumonia. Four hospital centers in Northern Italy conducted an observational retrospective cohort study during the first wave of COVID-19 pandemic. Four hundred and fifty-six patients with COVID-19 pneumonia admitted to medical or sub-intensive wards were enrolled. Clinical, laboratory, and respiratory parameters, for the calculation of different indices, were measured at hospital admission. In medical wards (Verona and Padua) the PaO2/FiO2 ratio, ROX index and SatO2/FiO2 ratio were able to predict intubation or death with good accuracy (AUROC for the PaO2/FiO2 ratio, ROX index and SatO2/FiO2 ratio of 75%, 75% and 74%, respectively). Regarding sub-intensive wards (Milan and Mantua), none of the three respiratory function indices was significantly associated with the composite outcome. In patients admitted to medical wards for COVID-19 pneumonia, the ROX index and the SatO2/FiO2 ratio demonstrated not only good performance in predicting intubation or death, but their accuracy was comparable to that of the PaO2/FiO2 ratio. In this setting, where repeated arterial blood gas tests are not always feasible, they could be considered a reliable alternative to the invasive PaO2/FiO2 ratio.

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Driving pressure and mortality in trauma without acute respiratory distress syndrome: a prospective observational study

Júnior¹,

Cardoso²,

Rieder³

2021

Revista Brasileira De Terapia Intensiva

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Peak Pressures and PaO2/FiO2 Ratios Are Associated With Adverse Outcomes in Patients on Mechanical Ventilators

Cited by 3 publications

References 7 publications

The Association Between the Mechanical Ventilator Pressures and Outcomes in a Cohort of Patients with Acute Respiratory Failure

The Association Between the Mechanical Ventilator Pressures and Outcomes in a Cohort of Patients with Acute Respiratory Failure

Performance of non-invasive respiratory function indices in predicting clinical outcomes in patients hospitalized for COVID-19 pneumonia in medical and sub-intensive wards: a retrospective cohort study

Driving pressure and mortality in trauma without acute respiratory distress syndrome: a prospective observational study

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