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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versão impressa ISSN 2448-8909
Resumo
ROJAS CORONA, Lizeth; VIDAL ANDRADE, Erick e CERON DIAZ, Ulises W. PaO2/FAO2 index: a better oxygenation indicator to assess hypoxemia? Results of an analysis of agreement with the PaO2/FiO2 index. Med. crít. (Col. Mex. Med. Crít.) [online]. 2023, vol.37, n.1, pp.21-25. Epub 30-Set-2023. ISSN 2448-8909. https://doi.org/10.35366/109958.
Introduction:
the PaO2/FiO2 ratio adjusted to barometric pressure is used to assess oxygenation in respiratory failure; however, it does not take PaCO2 into account, unlike the PaO2/FAO2 ratio (PaO2 divided by the alveolar fraction of oxygen).
Objective:
to evaluate the agreement between PaO2/FiO2 and PaO2/FAO2.
Material and methods:
observational, ambispective, cross-sectional and analytical study in patients older than 18 years, under invasive mechanical ventilation with respiratory failure and with different PaCO2 values.
Results:
agreement was analyzed in 64 gasometric measurements taken at admission and when the highest PaCO2 was documented, of 32 patients. The Bland and Altman analysis showed a mean of the differences (bias) of 13 and a 95% limit of agreement, between 54 and -24. Agreement is better when PaO2/FiO2 is greater than 150. Twenty two percent of the measurements did not agree in the assignment to groups with mild, moderate, or severe hypoxemia.
Conclusions:
there is moderate agreement between PaO2/FAO2 and PaO2/FiO2; however, in patients with severe hypoxemia, agreement is better. In patients with PaO2/FiO2 ≥ 150, hypercapnia partly explains the low agreement. PaO2/FAO2 is possibly a better way to assess the degree of oxygenation disturbance.
Palavras-chave : Kirby index; PaO2/FAO2 index; PaO2/FiO2 index.