Assessment of the SpO2/FiO2 ratio as a tool for hypoxemia screening in the emergency department - 28/05/21
, Eric Tellier, MD, PhD a, b, Caroline de la Rivière, MD a, Marie-Christine Beauvieux, MD, PhD c, d, Guillaume Valdenaire, MD e, Michel Galinski, MD, PhD a, b, Philippe Revel, MD a, b, Xavier Combes, MD, PhD a, b, Cédric Gil-Jardiné, MD, PhD a, bAbstract |
Objective |
We assessed the performance of the ratio of peripheral arterial oxygen saturation to the inspired fraction of oxygen (SpO2/FiO2) to predict the ratio of partial pressure arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) among patients admitted to our emergency department (ED) during the SARS-CoV-2 outbreak.
Methods |
We retrospectively studied patients admitted to an academic-level ED in France who were undergoing a joint measurement of SpO2 and arterial blood gas. We compared SpO2 with SaO2 and evaluated performance of the SpO2/FiO2 ratio for the prediction of 300 and 400 mmHg PaO2/FiO2 cut-off values in COVID-19 positive and negative subgroups using receiver-operating characteristic (ROC) curves.
Results |
During the study period from February to April 2020, a total of 430 arterial samples were analyzed and collected from 395 patients. The area under the ROC curves of the SpO2/FiO2 ratio was 0.918 (CI 95% 0.885–0.950) and 0.901 (CI 95% 0.872–0.930) for PaO2/FiO2 thresholds of 300 and 400 mmHg, respectively. The positive predictive value (PPV) of an SpO2/FiO2 threshold of 350 for PaO2/FiO2 inferior to 300 mmHg was 0.88 (CI95% 0.84–0.91), whereas the negative predictive value (NPV) of the SpO2/FiO2 threshold of 470 for PaO2/FiO2 inferior to 400 mmHg was 0.89 (CI95% 0.75–0.96). No significant differences were found between the subgroups.
Conclusions |
The SpO2/FiO2 ratio may be a reliable tool for hypoxemia screening among patients admitted to the ED, particularly during the SARS-CoV-2 outbreak.
Le texte complet de cet article est disponible en PDF.Highlights |
• | SpO2/FiO2 ratio could be a reliable tool for estimation of PaO2/FiO2 ratio among patients admitted for respiratory symptoms. |
• | Diagnostic performance seems to be unaffected by the presence or absence of COVID-19 infection. |
• | SpO2/FiO2 threshold of 370 showed satisfactory diagnostic performance for the positive diagnosis of PaO2/FiO2 < 300 mmHg. |
• | SpO2/FiO2 threshold of 450 showed satisfactory diagnostic performance for exclusion of PaO2/FiO2 < 400 mmHg. |
Keywords : Respiratory insufficiency, Oximetry, COVID-19, Triage, ROC curve
Plan
Vol 44
P. 116-120 - juin 2021 Retour au numéro
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