The value of oxygen index and base excess in predicting the outcome of neonatal acute respiratory distress syndrome

Abstract

Objective This study aimed to identify the predictors and threshold of failure in neonatal acute respiratory distress syndrome. Methods Newborns with severe acute respiratory distress syndrome aged 0–28 days and gestational age ≥36 weeks were included in the study if their cases were managed with non-extra corporal membrane oxygenation treatments. Patients were divided into two groups according to whether they died before discharge. Predictors of non-extra corporal membrane oxygenation treatment failure were sought, and the threshold of predictors was calculated. Results A total of 103 patients were included in the study. A total of 77 (74.8%) survived hospitalization and were discharged, whereas 26 (25.2%) died. Receiver operating characteristic analysis of oxygen index, pH, base excess, and combinations of these indicators demonstrated the advantage of the combination of oxygen index and base excess over the others variables regarding their predictive ability. The area under the curve for the combination of oxygen index and base excess was 0.865. When the cut-off values of oxygen index and base excess were 30.0 and −7.4, respectively, the sensitivity and specificity for predicting death were 77.0% and 84.0%, respectively. The model with base excess added a net reclassification improvement of 0.090 to the model without base excess. Conclusion The combination of oxygen index and base excess can be used as a predictor of outcomes in neonates receiving non-extra corporal membrane oxygenation treatment for acute respiratory distress syndrome. In neonates with acute respiratory distress syndrome, if oxygen index >30 and base excess <−7.4, non-extra corporal membrane oxygenation therapy is likely to lead to death.

Correlation and Prediction of Oxygen Index from Oxygen Saturation Index in Neonates with Acute Respiratory Failure

“…6 Moreover, OI was investigated as a prognostic tool for acute HRF in neonates. 7,8 However, the OI can be calculated in an intubated infant, needs mechanical ventilation, and requires an indwelling arterial catheter or arterial puncture. The severity of hypoxemia from OI is intermittently determined when arterial blood gas (ABG) samplings are obtained.…”

A prediction nomogram for neonatal acute respiratory distress syndrome in late-preterm infants and full-term infants: A retrospective study

“… 2 A multicentre study in China reported that the mortality rate of severe neonatal ARDS with a gestational age (GA) ≥36 weeks was 25·2%. 3 Compared with neonatal respiratory distress syndrome (RDS) incurred by primary pulmonary surfactant deficiency, neonatal ARDS may be more likely to affect late-preterm and full-term infants. 3 , 4 However, the aetiology and pathogenesis of neonatal ARDS remain unclear.…”

“… 3 Compared with neonatal respiratory distress syndrome (RDS) incurred by primary pulmonary surfactant deficiency, neonatal ARDS may be more likely to affect late-preterm and full-term infants. 3 , 4 However, the aetiology and pathogenesis of neonatal ARDS remain unclear.…”

Association Between Base Excess and Mortality Among Patients in ICU With Acute Kidney Injury

“…Base excess (BE) is defined as the amount of acid or alkali needed to adjust the value to the normal range ( 3 ), which is considered a pure indicator of metabolic acid–based balance ( 4 ). Base excess has been widely used as a predictor for the diagnosis of neonatal sepsis in pre-term newborns ( 5 ), complications in cytoreductive surgery ( 6 ), or the prognosis of neonatal acute respiratory distress syndrome ( 7 ). The indicator also shows significant representativeness in heart failure ( 3 , 4 ).…”