Document Detail

Comparison of the SpO2/FIO2 ratio and the PaO2/FIO2 ratio in patients with acute lung injury or ARDS.
MedLine Citation:
PMID:  17573487     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The diagnostic criteria for acute lung injury (ALI) and ARDS utilize the Pao(2)/fraction of inspired oxygen (Fio(2)) [P/F] ratio measured by arterial blood gas analysis to assess the degree of hypoxemia. We hypothesized that the pulse oximetric saturation (Spo(2))/Fio(2) (S/F) ratio can be substituted for the P/F ratio in assessing the oxygenation criterion of ALI.
METHODS: Corresponding measurements of Spo(2) (values </= 97%) and Pao(2) from patients enrolled in the ARDS Network trial of a lower tidal volume ventilator strategy (n = 672) were compared to determine the relationship between S/F and P/F. S/F threshold values correlating with P/F ratios of 200 (ARDS) and 300 (ALI) were determined. Similar measurements from patients enrolled in the ARDS Network trial of lower vs higher positive end-expiratory pressure (n = 402) were utilized for validation.
RESULTS: In the derivation data set (2,613 measurements), the relationship between S/F and P/F was described by the following equation: S/F = 64 + 0.84 x (P/F) [p < 0.0001; r = 0.89). An S/F ratio of 235 corresponded with a P/F ratio of 200, while an S/F ratio of 315 corresponded with a P/F ratio of 300. The validation database (2,031 measurements) produced a similar linear relationship. The S/F ratio threshold values of 235 and 315 resulted in 85% sensitivity with 85% specificity and 91% sensitivity with 56% specificity, respectively, for P/F ratios of 200 and 300.
CONCLUSION: S/F ratios correlate with P/F ratios. S/F ratios of 235 and 315 correlate with P/F ratios of 200 and 300, respectively, for diagnosing and following up patients with ALI and ARDS.
Todd W Rice; Arthur P Wheeler; Gordon R Bernard; Douglas L Hayden; David A Schoenfeld; Lorraine B Ware;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural     Date:  2007-06-15
Journal Detail:
Title:  Chest     Volume:  132     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-10-02     Revised Date:  2013-02-07    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  410-7     Citation Subset:  AIM; IM    
MSc, Division of Allergy, Pulmonary, and Critical Care Medicine, T-1218 MCN, Nashville, TN 37232-2650, USA.
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MeSH Terms
Middle Aged
Positive-Pressure Respiration / methods*
Pulmonary Diffusing Capacity / physiology
Pulmonary Gas Exchange
Reproducibility of Results
Respiratory Distress Syndrome, Adult* / blood,  diagnosis,  therapy
Severity of Illness Index
Tidal Volume
Treatment Outcome
Grant Support

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