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P/FP ratio: incorporation of PEEP into the PaO~2~/FiO~2~ ratio for prognostication and classification of acute respiratory distress syndrome by Palanidurai, Sunitha (author);Phua, Jason (author);Chan, Yiong Huak (author);Mukhopadhyay, Amartya (author) is a Medicine article available to read on EtoBox.

What is P/FP ratio: incorporation of PEEP into the PaO~2~/FiO~2~ ratio for prognostication and classification of acute respiratory distress syndrome about?

## Abstract ## Background The current Berlin definition of acute respiratory distress syndrome (ARDS) uses the PaO~2~/FiO~2~ (P/F) ratio to classify severity. However, for the same P/F ratio, a patient on a higher positive end-expiratory pressure (PEEP) may have more severe lung injury than one on a lower PEEP. ## Objectives We designed a new formula, the P/FP ratio, incorporating PEEP into the P/F ratio and multiplying with a correction factor of 10 [(PaO~2~\*10)/(FiO~2~\*PEEP)], to evaluate if it better predicts hospital mortality compared to the P/F ratio post-intubation and to assess the resultant changes in severity classification of ARDS. ## Methods We categorized patients from a dataset of seven ARDS network trials using the thresholds of ≤ 100 (severe), 101–200 (moderate), and 201–300 (mild) for both P/F (mmHg) and P/FP (mmHg/cmH~2~O) ratios and evaluated hospital mortality using areas under the receiver operating characteristic curves (AUC). ## Results Out of 3,442 patients, 1,057 (30.7%) died. The AUC for mortality was higher for the P/FP ratio than the P/F ratio for PEEP levels > 5 cmH~2~O: 0.710 (95% CI 0.691–0.730) versus 0.659 (95% CI 0.637–0.681), P < 0.001. Improved

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Author

Palanidurai, Sunitha (author);Phua, Jason (author);Chan, Yiong Huak (author);Mukhopadhyay, Amartya (author)

Publisher

Springer Science and Business Media LLC

Published

2021

Language

EN

Field

Medicine (Health Sciences)