Oleksandr V Oliynyk1, Marta Rorat2, Wojciech Barg3. 1. Department of Anesthesiology and Intensive Care, Bogomolets National Medical University, Kyiv, Ukraine; Department of Emergency Medicine, High Education State School named by Pope John Paul II, Biala Podlaska, Poland. 2. I Infectious Diseases Ward, J. Gromkowski Regional Specialist Hospital, Wroclaw, Poland; Department of Forensic Medicine, Wroclaw Medical University, Wroclaw, Poland. Electronic address: rorat.marta@gmail.com. 3. Department of Internal Medicine, Pneumonology and Allergology, Wroclaw Medical University, Wroclaw, Poland.
Abstract
OBJECTIVE: The aim of this paper was to find oxygen metabolism markers that could predict mortality in patients with severe COVID-19. METHODS: In a retrospective analysis we compared the medical records of patients with severe COVID-19 including 53 records of deceased patients and 50 records of survivors. The latter were selected from 222 records using a random number generator. For comparison, 28 individuals who considered themselves healthy and had no history of serious illness were also examined. Oxygen saturation in arterial blood (SaO2) and in central venous blood (ScvO2), arterial partial pressure of oxygen (PaO2), respiratory index (PaO2/FiO2), oxygen delivery (DO2), consumption (VO2) and extraction (O2ER) were compared in all participating individuals. Optimal cutoff point for oxygen parameters in prediction of death was performed using maximization of Youden Index in receiver operating characteristic (ROC) curve analysis. RESULTS: There were statistically significant differences between values of all studied oxygen metabolism markers in the survivors as compared to the deceased patients (p < 0.001). ScvO2, VO2 and O2ER (AUC 1.0) were the strongest predictors of mortality, while PaO2 the lowest (0.81). ScvO2 < 29%, VO2 > 124.6 ml/min and O2ER > 30.2% were found to be predictors of mortality in patients with COVID-19. CONCLUSION: Values of ScvO2, VO2 and O2ER appear to be good predictors of mortality in critically ill patients with COVID-19.
OBJECTIVE: The aim of this paper was to find oxygen metabolism markers that could predict mortality in patients with severe COVID-19. METHODS: In a retrospective analysis we compared the medical records of patients with severe COVID-19 including 53 records of deceased patients and 50 records of survivors. The latter were selected from 222 records using a random number generator. For comparison, 28 individuals who considered themselves healthy and had no history of serious illness were also examined. Oxygen saturation in arterial blood (SaO2) and in central venous blood (ScvO2), arterial partial pressure of oxygen (PaO2), respiratory index (PaO2/FiO2), oxygen delivery (DO2), consumption (VO2) and extraction (O2ER) were compared in all participating individuals. Optimal cutoff point for oxygen parameters in prediction of death was performed using maximization of Youden Index in receiver operating characteristic (ROC) curve analysis. RESULTS: There were statistically significant differences between values of all studied oxygen metabolism markers in the survivors as compared to the deceased patients (p < 0.001). ScvO2, VO2 and O2ER (AUC 1.0) were the strongest predictors of mortality, while PaO2 the lowest (0.81). ScvO2 < 29%, VO2 > 124.6 ml/min and O2ER > 30.2% were found to be predictors of mortality in patients with COVID-19. CONCLUSION: Values of ScvO2, VO2 and O2ER appear to be good predictors of mortality in critically illpatients with COVID-19.
Authors: Luke Bracegirdle; Alexander Jackson; Ryan Beecham; Maria Burova; Elsie Hunter; Laura G Hamilton; Darshni Pandya; Clare Morden; Michael P W Grocott; Andrew Cumpstey; Ahilanandan Dushianthan Journal: PLoS One Date: 2022-06-10 Impact factor: 3.752