Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Evaluation of Oxygenation Index, PEEP, PaFiP as an Outcome Predictor of Patients with New Onset Acute Respiratory Failure Receiving Invasive Mechanical Ventilation
L. Manikanta Chaitanya, B.S. Gopala Krishna, Velavarthipati Ravi Sankar, Raghu Kondle and B. Dhiran Showri
Page: 203-211 | Received 25 Sep 2024, Published online: 20 Dec 2024
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Abstract
The present prospective study was conducted on 61 patients in the department of emergency medicine, Narayana Medical College and Hospital, Nellore, over a period of two years. Respiratory failure characterized by inadequate blood oxygenation or carbon dioxide removal. "Adequacy" is defined by tissue requirements for oxygen uptake and carbon dioxide elimination. In AHRF where PaO2/FiO2 <200 mm of Hg where mechanical ventilation is used to reduce the hypoxemia and delay the consequences of the disease process. OI is used as a simple prognostic tool in identifying the high risk individuals who were on mechanical ventilation. The males and females were 54.1% and 45.9%. Mortality in the study population was 63.9% survivors and 36.1% non survivors. Mean pH among survivors and non survivors were 7.28 and 7.21 at day 1, 7.34 and 7.207 at day 3. Mean PaO2/FiO2 among survivors and non survivors were 200.6 and 134.1mm of Hg at day 1, 312.345 and 148.9 mm of Hg day 3. Mean PEEP among survivors and non survivors were 8.385 and 10.545 at day 1, 6.923 and 12.2 at day 3. Mean PaFip among survivors and non survivors were 2.23 and 1.764 at day 1,2.73 and 1.81 at day3. Mean OI among survivors and non survivors were 8.416 and 13.33 at day 1,5.15 and 12.914 at day 3. Mean SOFA among survivors and non survivors were 7.69 and 10.95 at day 1,7.23 and 11.33 at day 3. OI, PaFip has significant correlation in identifying the high risk group among the study population in comparison with SOFA. In the study population values of AUC of OI , PaFip and SOFA were 0.838,0.163,0.888 respectively. The SOFA score on day 3 and OI day 3 were compared and found that both the AUC was 0.947 and 0.957 respectively which were statistically significant. In mechanical ventilation patients with AHRF, OI can be used as a better prognostic outcome variable in identifying the high risk group. OI is a simplified bedside tool which can be compiled from ventilator parameters and blood gas analysis. Considering the limitations of the study, simplicity and feasibility of use of OI and determining the change in OI from day 1 to day 3 gives an outcome predictability similar to SOFA score and is more specificity. PaFip is also a variable showing the statistical significance in the study when compared with PaO2/FiO2 ratio alone.
How to cite this article:
L. Manikanta Chaitanya, B.S. Gopala Krishna, Velavarthipati Ravi Sankar, Raghu Kondle and B. Dhiran Showri. Evaluation of Oxygenation Index, PEEP, PaFiP as an Outcome Predictor of Patients with New Onset Acute Respiratory Failure Receiving Invasive Mechanical Ventilation.
DOI: https://doi.org/10.36478/10.36478/makrjms.2025.1.203.211
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2025.1.203.211