• Am J Emerg Med · Jun 2021

    Assessment of the SpO2/FiO2 ratio as a tool for hypoxemia screening in the emergency department.

    • Pierre Catoire, Eric Tellier, Caroline de la Rivière, Marie-Christine Beauvieux, Guillaume Valdenaire, Michel Galinski, Philippe Revel, Xavier Combes, and Cédric Gil-Jardiné.
    • Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France. Electronic address: pierre.catoire@chu-bordeaux.fr.
    • Am J Emerg Med. 2021 Jun 1; 44: 116120116-120.

    ObjectiveWe 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.MethodsWe 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.ResultsDuring 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.ConclusionsThe SpO2/FiO2 ratio may be a reliable tool for hypoxemia screening among patients admitted to the ED, particularly during the SARS-CoV-2 outbreak.Copyright © 2021. Published by Elsevier Inc.

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