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Utilidad de la relación Sao2/Fio2 en la evaluación del grado de compromiso pulmonar en pacientes críticos
oleh: Alonso Gómez Duque, Luis Alejandro León, Carlos Gómez Quintero, Gilberto Fernández, Marina Quijano Cuellar, Diana Quitián Ramírez
Format: | Article |
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Diterbitkan: | Universidad Nacional de Colombia 2002-01-01 |
Deskripsi
Background: Arteriovenous admixture or intrapulmonary shunt and the relation between PaO2 and FI02 (PaO2/FiO2 ) have been advocated as the main indicators of pulmonary function. Because the Pa02 is a measure of the oxygen given to the tissues, as well as the Sa02, we could expect a close relationship between the Pa02IFI02 index and a new one, the SaO2/FiO2 index, Methods: We conducted a prospective study in a cohortofl07 patients with different pathologies in an Intensive Care Unit, collecting 507 samples of arterial and central venous gases and measuring the Sa02 by pulse oximeter at the same time. PaO2/FiO2 and Sa O2/FiO2, as well as intrapulmonary shunt using invasive and noninvasive methods, were caIculated. The Lung Injury Score (LIS) and the Multiple Organ Dysfunction score were calculated too. Results: We found a good correlation between Sa O2/FiO2 and PaO2/FiO2. (R2=0,81,R=0.9), and between the intrapulmonary shuntfraction calculated with invasive and noninvasive methods.(R2=0.75, R=0.86). The data were correlationed with a simple linear regression analysis. Five groups of SaO2/FiO2 were found and a punctuation from Oto 4 was established for them, in a similar approach to the one used by Murray in the Lung Injury Score (LIS) and Marshall in the Multiple Organ Dysfunction score. By using this punctuation, we replaced the PaO2/FiO2 by the SaO2/FiO2 in the scale and recalculated the LIS finding a good correlation between the score with PaO2/FiO2 and the one with SaO2/FiO2 (R2=0.94,R=0.96). The same was true for the correlation between the Marshall score with PaO2/FiO2 and the one with SaO2/FiO2. (R2=O.85, R=0.92). The correlation was mantained when a stratified analysis was made according to the degree of severity of the pulmonary injury. Conclusions: SaO2/FiO2 is an useful indicator of the oxygenation in a similar way as the PaO2/FiO2 índex, It could be incorporated into the LIS and Marshall score with similar results. The usefulness of the intrapulmonary shunt calculated by noninvasive methods is confirmed.