Title: Pediatric ARDS continued...<br/>Author: Mimi Lu<br/><a href='http://umem.org/profiles/faculty/185/'>[Click to email author]</a><hr/><p>
Some pediatric practitioners have adopted the oxygenation index (OI) ([FiO2 × mean airway pressure (Paw) × 100]/ PaO2) or oxygen saturation index (OSI) ([FiO2 × Paw × 100]/ SpO2) to assess hypoxemia in children instead of P/F ratios because of the less standardized approach to positive pressure ventilation in children relative to adults. </p>
<p>
OI can be used in pediatric patients to define severity of Acute Respiratory Distress Syndrome (ARDS) in patients receiving <strong><u>invasive </u></strong>mechanical ventilation and assess for potential ECMO treatment. </p>
<p>
In contrast, the P/F ratio should be used to diagnose Pediatric ARDS for patients receiving <u><strong>noninvasive</strong></u> continuous positive airway pressure [CPAP] or bilevel positive airway pressure [BiPAP]) with a minimum CPAP of 5 cm H2O.</p>
<p>
Oxygen Index (OI) = FiO<sub>2</sub> x MAP x 100<br />
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PaO<sub>2</sub></p>
<ul>
<li>
Mild ARDS: 4 ≤ OI ≤ 8</li>
<li>
Moderate ARDS: 8 ≤ OI < 16</li>
<li>
Severe ARDS: OI ≥ 16</li>
</ul>
<ul>
<li>
OI < 25: good outcome</li>
<li>
OI 25-40: >40% mortality</li>
<li>
OI > 40: Consider ECMO</li>
</ul>
<fieldset><legend>References</legend>
<div class="cit">
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2) Pediatric Acute Respiratory Distress Syndrome: Consensus Recommendations from the Pediatric Acute Lung Injury Consensus Conference. <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Pediatric%20Acute%20Lung%20Injury%20Consensus%20Conference%20Group%5BCorporate%20Author%5D"><span class="highlight" style="background-color:">Pediatric</span> <span class="highlight" style="background-color:">Acute</span> Lung Injury <span class="highlight" style="background-color:">Consensus</span> Conference Group</a>. <span role="menubar"><a href="https://www.ncbi.nlm.nih.gov/pubmed/25647235#" role="menuitem" title="Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.">Pediatr Crit Care Med.</a></span> 2015 Jun;16(5):428-39</div>
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