Abstract
Aims & Objectives: To compare and analyse the relationship between Pao2/Fio2 (P/F) ratio and Spo2 /Fio2 (S/F) ratio in critically ill children requiring respiratory support. Methods Study was done over a period of 7 months in the PICU. All Children admitted in PICU, who require respiratory support (Non-invasive/ Invasive) are recruited in the study. Children with congenital heart disease, chronic lung disease, abnormal haemoglobin, etc., are excluded from the study. S/F ratio and P/F ratio was calculated twice for each participant, once at the time of recruitment and again at the time of deterioration (requiring escalation in the respiratory support) or 24 hours after recruitment, whichever is the earliest. Results We obtained a total of 250 samples from 125 participants. Among 125 children, 112 (89.5%) required invasive ventilation, 5 (4%) required face mask Non-invasive ventilation, 1 (0.8%) required nasopharyngeal CPAP and 7 (5.7%) required high flow nasal cannula therapy. In our study, 27 (21.6%) had ARDS. Our study showed, S/F ratio of less than 180 corresponds well with P/F ratio <200, with sensitivity and specificity of 90% and 59% respectively (AUROC-0.8). In other words, any child who require Fio2 of 50% or more to maintain a saturation of 90% (S/F ratio<180) are likely to have ARDS (P/F <200). Conclusions Our study showed a strong correlation between S/F ratio and P/F ratio. S/F ratio (<180) helps in early identification of children at risk of ARDS, especially in Paediatric Emergency and in secondary level settings where ABG is not available.
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