ArticleIntensive care medicine2013
A universal definition of ARDS: the PaO2/FiO2 ratio under a standard ventilatory setting--a prospective, multicenter validation study.
Article in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers, 7 of them syntheses that pooled it.
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Who cites it
106 citing papers in PubMed, 7 syntheses or guidelines pooled it, 203 citations in OpenAlex.
- Predictive Value of the PaOInternal medicine (Tokyo, Japan) · 2025Pooled it
- Impact of differences in acute respiratory distress syndrome randomised controlled trial inclusion and exclusion criteria: systematic review and meta-analysis.British journal of anaesthesia · 2021Pooled it
- Intubation rate of patients with hypoxia due to COVID-19 treated with awake proning: A meta-analysis.The American journal of emergency medicine · 2021Pooled it
- Ethnic and age-specific acute lung injury/acute respiratory distress syndrome risk associated with angiotensin-converting enzyme insertion/deletion polymorphisms, implications for COVID-19: A meta-analysis.Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases · 2021Pooled it
- Tidal volume and plateau pressure use for acute lung injury from 2000 to present: a systematic literature review.Critical care medicine · 2014Pooled it
- Effects of interventions on survival in acute respiratory distress syndrome: an umbrella review of 159 published randomized trials and 29 meta-analyses.Intensive care medicine · 2014Pooled it
- Enteral omega-3 fatty acid supplementation in adult patients with acute respiratory distress syndrome: a systematic review of randomized controlled trials with meta-analysis and trial sequential analysis.Intensive care medicine · 2014Pooled it
- Trial
- Assessment of PaO₂/FiO₂ for stratification of patients with moderate and severe acute respiratory distress syndrome.BMJ open · 2015Trial
- Beyond the PaOAnnals of intensive care · 2026Review
- The PaO2/FiO2 is a weak predictor of mortality for critically ill patients: limitations of an easy-to-calculate score.Critical care science · 2026Article
- Optimal Cutoffs for the Ratio of Arterial Oxygen Partial Pressure to Inspired Oxygen Fraction in Categorizing Respiratory Impairment Severity in Organ Failure Scores.Acta anaesthesiologica Scandinavica · 2026Article
- Exploring pharmacological strategies in the management of ARDS: Efficacy, limitations, and future directions.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Review
- Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies.Signal transduction and targeted therapy · 2025Review
- Machine learning derivation of two cardiac arrest subphenotypes with distinct responses to treatment.Journal of translational medicine · 2025Article
- Tocilizumab in COVID-19: A Double-Edged Sword?Biomedicines · 2024Article
- Association ofHeliyon · 2024Article
- Reinforcement learning for intensive care medicine: actionable clinical insights from novel approaches to reward shaping and off-policy model evaluation.Intensive care medicine experimental · 2024Article
- Predicting the Length of Mechanical Ventilation in Acute Respiratory Disease Syndrome Using Machine Learning: The PIONEER Study.Journal of clinical medicine · 2024Article
- Chest CT findings in severe acute respiratory distress syndrome requiring V-V ECMO: J-CARVE registry.Journal of intensive care · 2024Article
46 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe PaO2/FiO2 is an integral part of the assessment of patients with acute respiratory distress syndrome (ARDS). The American-European Consensus Conference definition does not mandate any standardization procedure. We hypothesized that the use of PaO2/FiO2 calculated under a standard ventilatory setting within 24 h of ARDS diagnosis allows a more clinically relevant ARDS classification.
methodsWe studied 452 ARDS patients enrolled prospectively in two independent, multicenter cohorts treated with protective mechanical ventilation. At the time of ARDS diagnosis, patients had a PaO2/FiO2 ≤ 200. In the derivation cohort (n = 170), we measured PaO2/FiO2 with two levels of positive end-expiratory pressure (PEEP) (≥ 5 and ≥ 10 cmH2O) and two levels of FiO2 (≥ 0.5 and 1.0) at ARDS onset and 24 h later. Dependent upon PaO2 response, patients were reclassified into three groups: mild (PaO2/FiO2 > 200), moderate (PaO2/FiO2 101-200), and severe (PaO2/FiO2 ≤ 100) ARDS. The primary outcome measure was ICU mortality. The standard ventilatory setting that reached the highest significance difference in mortality among these categories was tested in a separate cohort (n = 282).
resultsThe only standard ventilatory setting that identified the three PaO2/FiO2 risk categories in the derivation cohort was PEEP ≥ 10 cmH2O and FiO2 ≥ 0.5 at 24 h after ARDS onset (p = 0.0001). Using this ventilatory setting, patients in the validation cohort were reclassified as having mild ARDS (n = 47, mortality 17 %), moderate ARDS (n = 149, mortality 40.9 %), and severe ARDS (n = 86, mortality 58.1 %) (p = 0.00001).
conclusionsOur method for assessing PaO2/FiO2 greatly improved risk stratification of ARDS and could be used for enrolling appropriate ARDS patients into therapeutic clinical trials.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.