Trial reportBMJ open2015
Assessment of PaO₂/FiO₂ for stratification of patients with moderate and severe acute respiratory distress syndrome.
Trial report in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 68 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of PEEP and FiO2 in the Evaluation of Severity of ALI and ARDS
Acute Lung Injury: Epidemiology and Natural History. The ALIEN Study
Logistic Organ Dysfunction System Role in Predicting 30-day Mortality Outcome in Intensive Care Unit of dr. Cipto Mangunkusumo General Hospital Patients
Who cites it
68 citing papers in PubMed, 3 syntheses or guidelines pooled it, 146 citations in OpenAlex.
- Lung Ultrasound Score in COVID-19 Patients Correlates with POThe western journal of emergency medicine · 2024Pooled 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
- High-flow nasal cannulaTherapeutic advances in respiratory diseasePooled it
- Validation of age, PaORespiratory research · 2020Trial
- Context-specific regulatory genetic variation in MTOR dampens neutrophil-T cell crosstalk in pneumonia-associated sepsis.Nature communications · 2026Article
- Prognostic value of disease severity and mechanical ventilation intensity in acute respiratory distress syndrome: analysis of the LUNG SAFE cohort.The European respiratory journal · 2026Observational
- The PaO2/FiO2 is a weak predictor of mortality for critically ill patients: limitations of an easy-to-calculate score.Critical care science · 2026Article
- Clinical Phenotyping in Acute Respiratory Distress Syndrome: Steps Towards Personalized Medicine.Journal of clinical medicine · 2025Article
- ARDS Subphenotypes as a Guide to Therapy and Enrollment into Therapeutic Trials: Not So Fast.Journal of clinical medicine · 2025Article
- Lower tidal volume ventilation post-bilateral lung transplantation is associated with ventilator-free days.Acta anaesthesiologica Scandinavica · 2025Article
- A modified screening protocol for ARDS in patients with respiratory support based on SpOJournal of intensive medicine · 2025Article
- Article
- Novel Oxygenation and Saturation Indices for Mortality Prediction in COVID-19 ARDS Patients: The Impact of Driving Pressure and Mechanical Power.Journal of intensive care medicine · 2024Article
- Comparative Predictive Accuracies of the Simplified Mortality Score for the Intensive Care Unit, Sepsis Severity Score, and Standard Severity Scores for 90-day Mortality in Sepsis Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Predictors of mortality in hospitalised patients with COVID-19: a 1-year case-control study.BMJ open · 2024Article
- The Global Definition of Acute Respiratory Distress Syndrome: Ready for Prime Time?American journal of respiratory and critical care medicine · 2024Article
- Physiologic Markers of Disease Severity in ARDS.Respiratory care · 2023Review
- Redefining ARDS: a paradigm shift.Critical care (London, England) · 2023Review
- Predicting Persistent Acute Respiratory Failure in Acute Pancreatitis: The Accuracy of Two Lung Injury Indices.Digestive diseases and sciences · 2023Article
- Efficacy of remote ischaemic preconditioning on outcomes following non-cardiac non-vascular surgery: a systematic review and meta-analysis.Perioperative medicine (London, England) · 2023Review
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 13 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesA recent update of the definition of acute respiratory distress syndrome (ARDS) proposed an empirical classification based on ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO₂/FiO₂) at ARDS onset. Since the proposal did not mandate PaO₂/FiO₂ calculation under standardised ventilator settings (SVS), we hypothesised that a stratification based on baseline PaO₂/FiOv would not provide accurate assessment of lung injury severity.
designA prospective, multicentre, observational study.
settingA network of teaching hospitals.
participants478 patients with eligible criteria for moderate (100<PaO₂/FiO₂≤200) and severe (PaO₂/FiO₂≤100) ARDS and followed until hospital discharge.
interventionsWe examined physiological and ventilator parameters in association with the PaO₂/FiO₂ at ARDS onset, after 24 h of usual care and at 24 h under a SVS. At 24 h, patients were reclassified as severe, moderate, mild (200<PaO₂/FiO₂≤300) ARDS and non-ARDS (PaO₂/FiO₂>300). PRIMARY AND SECONDARY OUTCOMES: Group severity and hospital mortality.
resultsAt ARDS onset, 173 patients had a PaO₂/FiO₂≤100 but only 38.7% met criteria for severe ARDS at 24 h under SVS. When assessed under SVS, 61.3% of patients with severe ARDS were reclassified as moderate, mild and non-ARDS, while lung severity and hospital mortality changed markedly with every PaO₂/FiO₂ category (p<0.000001). Our model of risk stratification outperformed the stratification using baseline PaO₂/FiO₂ and non-standardised PaO₂/FiO₂ at 24 h, when analysed by the predictive receiver operating characteristic (ROC) curve: area under the ROC curve for stratification at baseline was 0.583 (95% CI 0.525 to 0.636), 0.605 (95% CI 0.552 to 0.658) at 24 h without SVS and 0.693 (95% CI 0.645 to 0.742) at 24 h under SVS (p<0.000001).
conclusionsOur findings support the need for patient assessment under SVS at 24 h after ARDS onset to assess disease severity, and have implications for the diagnosis and management of ARDS patients. TRIAL REGISTRATION NUMBERS: NCT00435110 and NCT00736892.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.