Predictive validity of effective shunt fraction in critically ill patients release_wodm7yq7hjb25iygj6um6mgtxy

Abstract

<jats:title>Abstract</jats:title>Accurate measurement of pulmonary oxygenation is important for classification of disease severity and quantification of outcomes in clinical studies. We compared predictive validity of established tension-based methods with two new measures of shunt fraction: (1) a non-invasive effective shunt (ES); and (2) inferred values from an integrated mathematical model of gas exchange (DB). Median absolute error (MAE) values for the four measures considered were: alveolar-arterial difference, 7.30kPa; P<jats:sub>a</jats:sub>O<jats:sub>2</jats:sub>/F<jats:sub>I</jats:sub>O<jats:sub>2</jats:sub> ratio, 2.41kPa; DB, 2.13kPa; ES: 1.88kPa. ES performed significantly better than other measures (p&lt;10<jats:sup>−10</jats:sup> in all comparisons). While the simplicity of P/F is suitable for routine use, the superior predictive validity of ES should make this measure the preferred choice where physiological accuracy is important, such as for use as surrogate outcome in clinical research.
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