Oxygenation Index Predicts Outcome of Acute Hypoxemic Respiratory Failure

Authors from The Hospital for Sick Children, Toronto reviewed data on all mechanically ventilated patients who required a positive end expiratory pressure (PEEP) ≥6 cm H₂O and a FiO₂ ≥0.5 for ≥12 hours to maintain adequate oxygenation. The authors sought to determine factors associated with prognosis for children with acute hypoxic respiratory failure and to analyze time-dependent risk of death and the utility of respiratory parameters for prognosis.

Patients with congenital or acquired heart disease, infants younger than 1 month, and those with severe neurological compromise were excluded. Data collection included demographic information, diagnosis and ventilator parameters, arterial blood gas measurements, measures of organ dysfunction, and Pediatric Risk of Mortality (PRISM) scores.¹ Oxygenation failure was measured serially by assessing alveolar-arterial oxygen gradient (A-a)DO₂, the …