• 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, and Ronald P Mlcak.
• 1Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX. 2Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. 3Department of Kinesiology and Sport Management, Texas Tech University, Lubbock TX 4Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany. 5Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX.
• Pediatr Crit Care Me. 2017 Oct 1; 18 (10): e472-e476.

ObjectivesDetermine 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.DesignRetrospective chart review.SettingShriners Hospitals for Children-Galveston.PatientsAll burned children with smoke inhalation injury who were admitted from 1996 to 2014 and had simultaneously obtained peripheral capillary oxygenation, FIO2 and PaO2 measurements.InterventionsNone.Measurements And Main ResultsTwo 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 r greater than 0.81. The r (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, r 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%.ConclusionsPaO2/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).

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