Chest
Original ResearchCritical CareClinical Characteristics and Outcomes Are Similar in ARDS Diagnosed by Oxygen Saturation/Fio2 Ratio Compared With Pao2/Fio2 Ratio
Section snippets
Study Design
We studied patients who were prospectively enrolled from January 23, 2006, to July 14, 2013, in the Validating Acute Lung Injury Markers for Diagnosis (VALID) study. The VALID study was designed to identify and validate plasma biomarkers for diagnosis and prognosis of ARDS, and all subjects in the study are carefully phenotyped for ARDS. The Vanderbilt University Institutional Review Board approved the study protocol (IRB #051065) with a waiver of informed consent. However, written informed
Characteristics of Patients Who Received a Diagnosis of ARDS by PF Ratio Compared With SF Ratio
A total of 362 patients with ARDS met the inclusion and exclusion criteria and were included in the current study (Fig 1). Of these, 238 patients with ARDS (66%) received a diagnosis by PF ratio, and 124 patients (34%) received a diagnosis by SF ratio. Table 1 includes a comparison of baseline characteristics and risk factors for ARDS between patients who received a diagnosis by PF and SF ratios.
Overall, patients with ARDS diagnosed by PF ratio had similar characteristics to patients who
Discussion
Because of continued uncertainty regarding the usefulness of the SF ratio for diagnosis of ARDS, we sought to investigate whether there are systematic differences between patients who received a diagnosis of ARDS by PF ratio compared with patients with ARDS diagnosed by SF ratio. In a large cohort of 362 carefully phenotyped patients with ARDS in the medical ICU, we found no differences in demographics, comorbidities, or severity of illness between patients with ARDS diagnosed by PF ratio
Acknowledgments
Author contributions: L. B. W. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis, including and especially any adverse effects. W. C. served as principal author. W. C. and L. B. W. contributed to the study concept design and writing of the manuscript; D. R. J., C. M. S., and J. A. B. contributed to data analysis and interpretation, study design, statistical analysis, and revision of the manuscript; and G.
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2024, Journal of Critical CareAn expanded definition of acute respiratory distress syndrome: Challenging the status quo
2023, Journal of Intensive MedicineCitation Excerpt :Brown et al.[18] found that the SpO2/FiO2 ratio may be reasonably used to substitute arterial blood gas for determining levels of hypoxemia in ARDS patients. Chen et al.[19] further confirmed that patients inferred to have ARDS based on the SpO2/FiO2 ratio did not have different clinical outcomes compared to those diagnosed based on the PaO2/FiO2 ratio. As the Berlin definition has been developed with reference to resource-rich settings and does not apply to resource-constrained settings, the Kigali modification of the Berlin definition has been proposed for use in the latter.
Pulse oximetry for the diagnosis and management of acute respiratory distress syndrome
2022, The Lancet Respiratory MedicineCitation Excerpt :In a study that directly compared medical ICU patients diagnosed with ARDS by arterial blood gas analysis versus pulse oximetry in a US tertiary care centre, baseline clinical characteristics and clinical outcomes including mortality were similar.31 Additionally, severe ARDS according to the pulse-oximetric criterion had a stronger association with mortality than severe ARDS diagnosed by arterial blood gas analysis, and diagnostic discordance was rare.31 Because SpO2 is continuously available, the SpO2/FiO2 ratio can be followed longitudinally more easily than the PaO2/FiO2 ratio, increasing available data for prognostication.
originally published Online First August 13, 2015
FUNDING/SUPPORT: This study was funded by the National Institutes of Health [Grants NIH HL103836, HL112656-02, T32 HL087738, and UL1 RR024975], an American Heart Association Clinical Research Award, and an American Heart Association Established Investigator Award.