Abstract
Background: The SpO2 to FiO2 ratio (S/F) is an easy to obtain and widely available oxygenation index with proven prognostic value in ARDS patients.
Aim: To ascertain the prognostic value of S/F and PEEP in COVID-19 ARDS patients.
Methods: Multicenter observational study in 22 ICUs in the Netherlands. 867 patients were stratified into four risk groups using 190 as the cutoff for S/F and 10 cm H2O as the cutoff for PEEP, on the day of the start of ventilation (day 0) and after 24 hours (day 1). The primary outcome was 28-day mortality.
Results: Risk stratification on day 0 resulted in groups with contrasting 28-day mortality and other endpoints; risk stratification on day 1 increased contrast in the outcomes.
Conclusions: Risk classification using S/F and PEEP has prognostic value in COVID-19 ARDS patients, which improves with reclassification on day 1.
| Group I | Group II | Group III | Group IV | p-value | |
| SpO2/FiO2 ≥ 190 and PEEP < 10 | SpO2/FiO2 ≥190 and PEEP ≥10 | SpO2/FiO2 < 190 and PEEP < 10 | SpO2/FiO2 < 190 and PEEP ≥ 10 | ||
| Day 0 | |||||
| N= | 18 | 139 | 50 | 660 | |
| ICU mortality | 6 (33%) | 29 (22%) | 18 (36%) | 241 (31%) |
0.002 |
| 28 day mortality | 5 (28%) | 29 (21%) | 17 (34%) | 217 (33%) | 0.015 |
| ICU length of stay | 11 [7-23] | 14 [9-25] | 14 [9-24] | 16 [9-27] | 0.358 |
| Duration of ventilation | 9 [4-18] | 13 [7-23] | 12 [6-20] | 14 [8-23] | 0.136 |
| Ventilator free days on day 28 | 15 [0-23] | 9 [0-19] | 2 [0-19] | 0 [0-15] | 0.002 |
| Day 1 | |||||
| N= | 57 | 359 | 37 | 414 | |
| ICU mortality | 18 (32%) | 99 (28%) | 16 (46%) | 161 (40%) | 0,002 |
| 28 day mortality | 17 (30%) | 87 (25%) | 14 (38%) | 150 (37%) | 0,001 |
| ICU length of stay | 10 [5-23] | 15 [9-26] | 15 [10-23] | 17 [9-29] | 0,004 |
| Duration of ventilation | 9 [4-18] | 14 [8-22] | 12 [7-20] | 15 [8-24] | 0.001 |
| Ventilator free days on day 28 | 14 [0-22] | 7 [0-17] | 0 [0-18] | 0 [0-13] | <0.001 |
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA896.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021
