Evidence map›Paper›PMID 31821205›Full record

Observational studyPediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2020

Early Hyperoxemia and Outcome Among Critically Ill Children.

Sriram Ramgopal, Cameron Dezfulian, Robert W Hickey, Alicia K Au, Shekhar Venkataraman, Robert S B Clark, Christopher M Horvat

Abstract readObservational Study
In one paragraph

Observational study in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Maximum PaoCritical care explorations · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sriram RamgopalDepartment of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
Cameron DezfulianDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Robert W HickeyDepartment of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
Alicia K AuDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Shekhar VenkataramanDepartment of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
Robert S B ClarkDepartment of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
Christopher M HorvatDepartment of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.

Funding

Mixed graphical models for the prediction of neurological morbidity in the PICUK23NS104133 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI AU, ALICIA K · 2018 to 2022
$947k
NINDS NIH HHS K23 NS104133
6 · The paper itself

Abstract

objectiveTo identify whether a high PaO2 (hyperoxemia) at the time of presentation to the PICU is associated with in-hospital mortality.

designSingle-center observational study.

settingQuaternary-care PICU. PATIENTS: Encounters admitted between January 1, 2009, and December 31, 2018.

interventionsNone. MEASUREMENTS AND MAIN

resultsEncounters with a measured PaO2 were included. To account for severity of illness upon presentation, we calculated a modified Pediatric Risk of Mortality IV score excluding PaO2 for each encounter, calibrated for institutional data. Logistic regression was used to determine whether hyperoxemia (PaO2 ≥ 300 torr [39.99 kPa]) in the 12 hours surrounding PICU admission was associated with in-hospital mortality. We reperformed our analysis using a cutoff for hyperoxemia obtained by comparisons of observed versus predicted mortality when encounters were classified by highest PaO2 in 50 torr (6.67 kPa) bins. Results are reported as adjusted odds ratios with 95% CIs. Of 23,719 encounters, 4,093 had a PaO2 recorded in the period -6 to +6 hours after admission. Two hundred seventy-four of 4,093 (6.7%) had in-hospital mortality. The prevalence of hyperoxemia increased with rising modified Pediatric Risk of Mortality IV and was not associated with mortality in multivariable models (adjusted odds ratio, 1.38; 95% CI, 0.98-1.93). When using a higher cutoff of hyperoxemia derived from comparison of observed versus predicted rates of mortality of greater than or equal to 550 torr (73.32 kPa), hyperoxemia was associated with mortality (adjusted odds ratio, 2.78; 95% CI, 2.54-3.05).

conclusionsA conventional threshold for hyperoxemia at presentation to the PICU was not associated with in-hospital mortality in a model using a calibrated acuity score. Extreme states of hyperoxemia (≥ 73.32 kPa) were significantly associated with in-hospital mortality. Prospective research is required to identify if hyperoxemia before and/or after PICU admission contributes to poor outcomes.

Indexed as

Hospital MortalityAdolescentBlood Gas AnalysisChildChild, PreschoolCritical IllnessEarly DiagnosisFemaleHumansHyperoxiaHypoxiaIntensive Care Units, PediatricLogistic ModelsMaleOutcome Assessment, Health CareOxygenOxygen

Identifiers

PMID31821205
PMCPMC7304556

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Registered 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.