tailieunhanh - Báo cáo khoa học: "Clinical relevance of the PaO2/FiO2 ratio"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Clinical relevance of the PaO2/FiO2 ratio. | Available online http content 12 1 407 Letter Clinical relevance of the Pao2 Fio2 ratio Mohamad F El-Khatib1 and Gassan W Jamaleddine2 American University of Beirut PO Box 11-0236 Beirut 1107-2020 Lebanon 2SUNY Downstate Medical Center 450 Clarkson Ave Brooklyn New York 11203 USA Corresponding author Mohamad F El-Khatib mk05@ Published 14 February 2008 This article is online at http content 12 1 407 2008 BioMed Central Ltd Critical Care 2008 12 407 doi cc6777 See related research by Karbing et al. http content 11 6 R118 We read with interest the report by Karbing and coworkers 1 in which they assess the clinical relevance of variation in the arterial oxygen tension PaO2 fractional inspired oxygen FiO2 ratio a widely used oxygenation index alongside changes in Fio2. In mechanically ventilated and spontaneously breathing patients they showed that the clinical utility of PaO2 FiO2 ratio is doubtful unless the FiO2 level at which the PaO2 FiO2 ratio is measured is specified. They included data from 28 mechanically ventilated patients and from an additional eight mechanically ventilated patients at one or two different positive end-expiratory pressure PEEP settings. We commend Karbing and coworkers and agree with their findings in patients who are spontaneously breathing. However for mechanically ventilated patients we believe that the PaO2 FiO2 ratio might not be the best reflection of oxygenation status. We have previously developed a new oxygenation index Pao2 Fio2 X MAP where MAP is the mean airway pressure and showed that the new oxygenation index is superior to Pao2 Fio2 ratio in reflecting intrapulmonary shunting and lung oxygenation status in mechanically ventilated patients 2 . By incorporating MAP Pao2 Fio2 X MAP can better account for the functional status of the lung resulting from changes in end-expiratory lung volume caused by manipulation of PEEP and or inspiratory to expiratory I E ratio. It would .