氧化指数,氧和指数与PaO2/FiO2 *PEEP:对OXIVA-CARDS研究的二次分析
Sonali Mr Vadi1, Neha Sanwalka2, Durga Suthar1
1Department of Intensive Care Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India.
氧化指数 (OI) 和氧和指数 (OSI) 是比传统的P / F比率更敏感的预测者,比传统的P / F比率更容易预测COVID-19相关的ARDS中的死亡率. 包括气道压力在内的OI显示出对死亡率的预测能力提高.
科学领域:
- 临界护理医学 临界护理医学
- 呼吸系统医学 呼吸系统医学
- 肺部病理学 肺部病理学
背景情况:
- 柏林对ARDS的定义依赖于PaO2/FiO2比率,这表明与死亡率的相关性很差.
- 气道压力是肺部遵守和机械通风器设置的关键指标.
研究的目的:
- 为了评估[PaO2/FiO2 × PEEP] (P/FP) 的比率来对ARDS严重程度进行分类,与传统的P/F比率相比.
- 为了确定P/FP比率是否能改善COVID-19患者住院死亡率的预测.
主要方法:
- 对OXIVA-CARDS研究数据的二次分析.
- 评估氧化指数 (OI) 和氧和指数 (OSI) 与P/FP比率和死亡风险相关.
- 使用了皮尔森的相关性,ROC分析与Youden的指数,以及多重后勤回归.
主要成果:
- 34%的患者被重新分类到不同的ARDS严重程度类别,使用P/FP比率.
- 根据P/FP的严重ARDS与P/F比率 (p <0.05) 的严重ARDS相比,P/FP,OI和A-a O2梯度明显较低.
- 在多变量回归分析中,只有OI对死亡率有显著影响 (p < 0.05).
结论:
- 氧化指数 (OI) 和氧和指数 (OSI) 显示出比PaO2/FiO2和P/FP比率更高的灵敏度.
- OI是死亡率的唯一显著预测因素.
- 将气道压力纳入OI计算提高了其对死亡率的预测能力,而不是P/F或P/FP比率.
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