VALIDITY OF USING THE SPO2/FIO2 RATIO TO DETERMINE THE DYNAMICS AND CORRECTION METHODS OF OXEMIA IN ACUTE LUNG INJURY AND ACUTE RESPIRATORY DISTRESS SYNDROME

Continuous monitoring of oxemia in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) is essential for successful therapy. AIM: To substantiate the validity of the use of pulse oximetry to determine the dynamics of oxemia in patients with ALI and ARDS and approbation of the "Mechanical Ventilation Expert"(MV Expert) smartphone application in a clinical setting. MATERIALS AND METHODS: The study included 588 patients with ALI and ARDS. The interdependence of 1188 data pairs (SpO(2) and PaO2) was analyzed. In case of hypoxemia, the parameters of respiratory support were corrected with and without the use of the "MV Expert" application. ROC curves and linear regression analysis were used for data processing. RESULTS: The prognostic value of SpO(2) and PaO2 in this group of patients was almost equivalent. At SpO(2) values from 91% to 93%, hypoxemia (PaO2 < 60 mmHg) was noted in 11.9% (142/1189) of data pairs, and at SpO(2) from 94% to 96% this condition was confirmed in 1.3% (16/1189) of data pairs. In cases where the recommendations of the "MV Expert" application were followed, oxemia indicators increased significantly more often (p = 0.002) and by more significant values (with p=0.007 for SpO(2) and p = 0.001 for PaO2) than in cases when doctors adjusted settings based on their own experience. CONCLUSION: With a high degree of probability, SpO(2) dynamics shows significant changes in oxemia in patients with ALI and ARDS. At SpO(2) from 94% to 96%, the development of hypoxemia (PaO2 < 60 mmHg) was observed in 1.3% of cases. The use of the "MV Expert" application increases the effectiveness of respiratory support.