Correlation between Pao2/Fio2 and peripheral capillary oxygenation/Fio2 in burned children with smoke inhalation injury

Janos Cambiaso-Daniel, Charles D. Voigt, Eric Rivas, Gabriel Hundeshagen, Omar Nunez-Lopez, Lars Peter Kamolz, Michaela Sljivich, Linda E. Sousse, David N. Herndon, Oscar E. Suman, Michael P. Kinsky, Ronald P. Mlcak

Research output: Contribution to journalArticle

Abstract

Objectives: Determine whether the peripheral capillary oxygenation/Fio2 ratio correlates with the Pao2/Fio2 ratio in burned children with smoke inhalation injury, with the goal of understanding if the peripheral capillary oxygenation/Fio2 ratio can serve as a surrogate for the Pao2/Fio2 ratio for the diagnosis of acute respiratory distress syndrome. Design: Retrospective chart review. Setting: Shriners Hospitals for Children - Galveston. Patients: All burned children with smoke inhalation injury who were admitted from 1996 to 2014 and had simultaneously obtained peripheral capillary oxygenation, Fio2 and Pao2 measurements. Interventions: None. Measurements and Main Results: Two hundred seventy-three patients (63% male, 8 ± 5 yr, 53% ± 24% total body surface area burns) were analyzed. Peripheral capillary oxygenation/Fio2 ratios were divided into four subgroups based on peripheral capillary oxygenation values (≤ 100%, ≤ 98%, ≤ 95%, and ≤ 92%). Significance was accepted at r2 greater than 0.81. The r2 (number of matches) was 0.66 (23,072) for less than or equal to 100%, 0.87 (18,932) for less than or equal to 98%, 0.89 (7,056) for less than or equal to 95%, and 0.93 (4,229) for less than or equal to 92%. In the subgroup of patients who developed acute respiratory distress syndrome, r2 was 0.65 (8,357) for less than or equal to 100%, 0.89 (7,578) for less than or equal to 98%, 0.89 (4,115) for less than or equal to 95%, and 0.91 (2,288) less than or equal to 92%. Conclusions: Pao2/Fio2 and peripheral capillary oxygenation/Fio2 strongly correlate in burned children with smoke inhalation injury, with a peripheral capillary oxygenation of less than 92% providing the strongest correlation. Thus, peripheral capillary oxygenation/Fio2 ratio may be able to serve as surrogate for Pao2/Fio2, especially when titrating Fio2 to achieve a peripheral capillary oxygenation of 90-95% (i.e., in the acute respiratory distress syndrome range).

Original languageEnglish (US)
Pages (from-to)e472-e476
JournalPediatric Critical Care Medicine
Volume18
Issue number10
DOIs
StatePublished - Oct 1 2017

Keywords

  • Acute lung injury
  • Acute respiratory distress syndrome
  • Critical care
  • Pediatric Acute Lung Injury Consensus Conference
  • Trauma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

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    Cambiaso-Daniel, J., Voigt, C. D., Rivas, E., Hundeshagen, G., Nunez-Lopez, O., Kamolz, L. P., Sljivich, M., Sousse, L. E., Herndon, D. N., Suman, O. E., Kinsky, M. P., & Mlcak, R. P. (2017). Correlation between Pao2/Fio2 and peripheral capillary oxygenation/Fio2 in burned children with smoke inhalation injury. Pediatric Critical Care Medicine, 18(10), e472-e476. https://doi.org/10.1097/PCC.0000000000001287