Are Oxygen Indices Effective for Predicting Pathological Intrapulmonary Shunt in Mechanically Ventilated Children?

This study was undertaken to evaluate whether oxygen indices accurately predict pathological intrapulmonary shunt (Qsp/Qt), and to evaluate the sensitivity and specificity of the FiO 2-required formula to obtain a desired arterial oxygen tension (PaO 2) in mechanically ventilated children. A prospec...

Full description

Saved in:
Bibliographic Details
Published in:Archives of medical research 1999-05, Vol.30 (3), p.179-185
Main Authors: Maulen-Radovan, Irene, Castrellón, Pedro Gutiérrez, Ochoa, Enna Cosio, Aguirre, Martha Márquez
Format: Article
Language:English
Subjects:
Adolescent
Biological Transport - physiology
Blood gases
Child
Child, Preschool
Children
Critical Illness
FiO 2
Humans
Infant
Lung - blood supply
Lung - metabolism
Oxygen - blood
Oxygen indices
Predictive Value of Tests
Prospective Studies
Pulmonary shunt
Respiration, Artificial
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:This study was undertaken to evaluate whether oxygen indices accurately predict pathological intrapulmonary shunt (Qsp/Qt), and to evaluate the sensitivity and specificity of the FiO 2-required formula to obtain a desired arterial oxygen tension (PaO 2) in mechanically ventilated children. A prospective, hospital-based, comparative study was conducted on 50 mechanically ventilated children at the Intensive Care Units of the National Institute of Pediatrics (INP) in Mexico City. Blood gas data were prospectively collected from 50 critically ill, mechanically ventilated children, 50 taken before and 40 after FiO 2 change. Assessment of Qsp/Qt, P(A-a)O 2, PaO 2/FiO 2, PaO 2/PAO 2, and P(A-a)O 2/PaO 2 was carried out before and after FiO 2 change. In first blood gas data, 31 patients were hypoxemic (PaO 2 100 Torr). Forty patients required FiO 2 modifications that were carried out according to Maxwell’s formula. Five children showed persistent oxygen disturbance after FiO 2 changes. P(A-a)O 2, PaO 2/FiO 2, PaO 2/PAO 2, and P(A-a)O 2/PaO 2 had sensitivities of 0.66, 0.71, 0.98, and 0.93, respectively, and specificities of 0.79, 0.91, 0.29, and 0.64, respectively, to detect pathological Qsp/Qt. All oxygen indices changed significantly after FiO 2 modifications compared from initials; Qsp/Qt also showed significant change after FiO 2 change. Pearson product-moment showed lineal correlation between each index, and Qsp/Qt demonstrated their significant correlation ( p
ISSN:0188-4409
1873-5487
DOI:10.1016/S0188-0128(99)00012-3