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such as in the sequential multiple organ damage assessment &#40;SOFA&#41; scale&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The measurement of arterial blood gases is required to determine PaO2 and calculate the PaO2&#47;FiO2 ratio&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">5&#44;6</span></a> However&#44; this technique can present limitations in its use&#44; either because of difficulty in taking the sample &#40;either because it requires trained personnel&#44; complicated arterial accesses&#44; constant puncture requirements&#44; pain at the time of sample collection and skin laceration&#41; or because it represents an increase in hospital costs&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A non-invasive substitute for the PaO2&#47;FiO2 ratio is the ratio of the percentage of hemoglobin saturation measured by pulse oximetry &#40;SpO2&#41; and the inspired fraction of oxygen &#40;FIO2&#41; &#40;SpO2&#47;FiO2&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">9</span></a> That allows the assessment and classification of the severity of respiratory failure<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">10</span></a> without the need for arterial blood sampling&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">11</span></a> Other methods have been proposed to estimate PaO2 without direct measurement of oxygen in arterial blood&#46; These models ensure their equivalence by imputing PaO2 from SpO2&#46; These imputation techniques can be classified into those that simulate the hemoglobin dissociation curve &#40;non-linear&#41;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;13</span></a> and those that take into account other types of relationships &#40;linear and logarithmic&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">14&#44;15</span></a> The studies that have compared these formulas show an adequate relationship between measured and imputed PaO2 values&#44; 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non-invasive methods &#40;linear&#44; non-linear&#44; logarithmic imputation of PaO2&#47;FiO2 and SpO2&#47;FiO2&#41; in patients living at 2600 a&#46;s&#46;l&#46; and under invasive mechanical ventilation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Methodology</span><p id="par0025" class="elsevierStylePara elsevierViewall">Ambispective cohort study was conducted in patients hospitalized in intensive care units with invasive ventilatory support in two third-level care hospitals in Colombia&#44; the Santa Clara Hospital in the city of Bogota &#40;Altitude&#58; 2640<span class="elsevierStyleHsp" style=""></span>m above sea level&#41; and the Cl&#237;nica Universidad de La Sabana in the city of Chia &#40;Altitude&#58; 2562<span class="elsevierStyleHsp" style=""></span>m above sea level&#41;&#46; The data was initially collected retrospectively&#44; from June 2016 to April 2019&#44; and prospectively from April to June 2019&#59; information was obtained from the electronic medical records from the period of hospitalization&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Patients</span><p id="par0030" class="elsevierStylePara elsevierViewall">Subjects over 18 years old&#44; with at least 24<span class="elsevierStyleHsp" style=""></span>h of invasive mechanical ventilation from any cause&#44; with simultaneous arterial gases and SpO2 measurements&#44; were included&#44; regardless of the saturation value&#44; severity of the disease&#44; type of ventilatory mode&#44; vasopressor support&#44; or radiological involvement&#46; Patients without concomitant measurements of arterial gases&#44; SpO2 and ventilatory parameters were excluded&#46; Patients with terminal disease&#44; extracorporeal membrane oxygenation and those in whom FiO2&#44; PaO2&#44; and SpO2 data had not been reported in the clinical records or had bad quality in the pulse wave were also excluded&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Variables</span><p id="par0035" class="elsevierStylePara elsevierViewall">Information was collected on age&#44; sex&#44; skin pigmentation&#44; type of pathology of entry&#44; weight&#44; height&#44; vital signs&#44; values of hemoglobin&#44; hematocrit&#44; bilirubin&#44; and creatinine&#44; findings on chest radiography&#44; with verification of the presence of infiltrates and the number of quadrants involved&#44; SOFA severity score&#44; vasopressor support&#44; ventilatory support parameters &#40;PEEP level &#62;10 and &#60;10<span class="elsevierStyleHsp" style=""></span>cmH20&#44;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">17&#44;18</span></a> peak pressure&#44; plateau pressure&#44; tidal volume&#41;&#44; total arterial gas values and oxygenation rates&#44; days of mechanical ventilation&#44; intensive care unit &#40;ICU&#41; and hospital stays&#46; Severe hypoxemia was the value of the PaO2&#47;FiO2 ratio obtained from arterial gases less than 150&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">19&#44;20</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Severingaus-Ellis&#40;no linear&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">21&#44;22</span></a> Rice &#40;linear&#41;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> and Pandharipande &#40;logarithmic linear&#41;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> formulas were used to calculate imputed PaO2 from SpO2&#46; The values of imputed PaO2 were used for the calculation of imputed PaO2&#47;FiO2&#59; besides&#44; SpO2&#47;FiO2 was calculated simultaneously&#46; The blood sample for arterial gases analysis was obtained through an arterial line&#59; the oximeters used measure the saturation through an infrared sensor with a wavelength of 905<span class="elsevierStyleHsp" style=""></span>nm 2&#46;0<span class="elsevierStyleHsp" style=""></span>mW with an error range of 1&#37;&#59; verification and calibration were performed daily during the study&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">All the subjects admitted to the ICU of both institutions during the study period were included&#46; In order to reduce errors in data collection and transcription&#44; the data were recorded by double typing and reviewed by two members of the research team&#46; This protocol was approved by the ethics committee of the Cl&#237;nica Universidad de La Sabana&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">An initial descriptive analysis was carried out&#44; summarizing the qualitative variables in frequencies and percentages&#44; the quantitative variables with normal distribution in means and standard deviation and if they did not meet the criteria of normality in medians and interquartile ranges&#46; The qualitative variables were compared through the chi-square test and the quantitative ones with Student&#39;s t-test or Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test according to their distribution&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">We applied the intraclass correlation coefficient between the values obtained from imputed PaO2&#44; PaO2&#47;FiO2 derived from the imputation methods&#44; and the SpO2&#47;FiO2 with the PaO2&#47;FiO2 of the arterial gases&#46; We considered the correlations thus&#58; 0&#8211;0&#46;3 null&#59; 0&#46;31&#8211;0&#46;50 low&#59; 0&#46;51&#8211;0&#46;70 moderate&#59; 0&#46;76&#8211;1&#46;00 strong&#46; The Bland&#8211;Altman method was used to evaluate the concordance&#46; For the validity&#44; the area under the ROC curve of the quantitative values obtained through the three imputation methods and the SpO2&#47;FiO2 value was calculated&#44; comparing it with the value of the arterial gases of severe hypoxemia &#40;PaO2&#47;FiO2<span class="elsevierStyleHsp" style=""></span>&#60;&#61;<span class="elsevierStyleHsp" style=""></span>150&#41;&#44; to obtain the best cut-off point using the Youden index and calculating the values of sensitivity&#44; specificity&#44; positive predictive value &#40;PPV&#41;&#44; negative predictive value &#40;NPV&#41;&#44; positive and negative likelihood ratio&#46; The ROC area was also used to establish the equivalence ranges between the different SpO2&#47;FiO2 measurements&#46; A <span class="elsevierStyleItalic">p</span>-value of less than 0&#46;05 was considered significant&#46; The statistical analysis was performed with the SPSS 22&#46;0 licensed program &#40;Statistical Package for the Social Sciences&#44; Chicago&#44; IL&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">We included a total of 664 patients during the study period&#44; the general characteristics of the patients were described according to positive end-expiratory pressures &#40;PEEP&#41; greater or less than 10<span class="elsevierStyleHsp" style=""></span>cm H2O and are showed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Among the general characteristics&#44; it was found that the patients had an mean age of 56<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20 years&#44; with a male predominance 444&#47;664 &#40;67&#37;&#41;&#44; most of the pathological conditions on admission were non-surgical &#40;81&#37;&#41;&#44; the mean SOFA was 15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2 points&#44; and 56&#37; of the patients required vasoactive support&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Arterial gases and mechanical ventilation</span><p id="par0065" class="elsevierStylePara elsevierViewall">The mean PaO2 was 83&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;5<span class="elsevierStyleHsp" style=""></span>mmHg&#44; SpO2 92&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;3&#37;&#44; PaCO2 33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;9<span class="elsevierStyleHsp" style=""></span>mmHg&#44; and bicarbonate 21&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6<span class="elsevierStyleHsp" style=""></span>mEq&#47;L&#44; with no significant differences between subgroups&#46; The pH was 7&#46;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;11 and the base excess &#8722;1&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4<span class="elsevierStyleHsp" style=""></span>mEq&#47;L&#46; The ventilatory parameters were a tidal volume of 481<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>58&#46;3<span class="elsevierStyleHsp" style=""></span>ml&#44; FIO2 of 50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>19&#37;&#44; plateau pressure 19&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;3<span class="elsevierStyleHsp" style=""></span>cmH2O&#44; and driving pressure of 10&#46;8<span class="elsevierStyleHsp" style=""></span>cmH2O&#46; The mean time of mechanical ventilation was 7&#46;1 days&#44; ICU length of stay was 10&#46;4 days and overall mortality was 18&#37;&#46; &#40;<a class="elsevierStyleCrossRef" href="#sec0065">Supplementary Material</a>&#41;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Correlation and validity results</span><p id="par0070" class="elsevierStylePara elsevierViewall">The correlation between PaO2&#47;FiO2 obtained from arterial gases&#44; PaO2&#47;FiO2 derived from one of the proposed methods &#40;linear&#44; non-linear&#44; and logarithmic formula&#41;&#44; and SpO2&#47;FiO2 measured by the intraclass correlation coefficient was high &#40;greater than 0&#46;77&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The different imputation methods and SpO2&#47;FiO2 have a similar diagnostic performance in patients with severe hypoxemia &#40;PaO2&#47;FiO2 &#60;150&#41;&#44; with an area under the ROC curve greater than 0&#46;8 with a similar sensitivity and specificity&#44; PaO2&#47;FiO2 linear imputation AUC ROC 0&#46;84 &#40;IC 0&#46;81&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; PaO2&#47;FiO2 logarithmic imputation AUC ROC 0&#46;84 &#40;IC 0&#46;80&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; PaO2&#47;FiO2 non-linear imputation AUC ROC 0&#46;82 &#40;IC 0&#46;79&#8211;0&#46;85&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; SpO2&#47;FiO2 oximetry AUC ROC 0&#46;84 &#40;IC 0&#46;81&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> and <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">We found that the correlation of the different methods applied &#40;imputation and SpO2&#47;FIO2&#41; decreased with hemoglobin levels equal to or less than 7<span class="elsevierStyleHsp" style=""></span>g&#47;dl &#40;0&#46;58 <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; as well as with total bilirubin values equal to or greater than 3<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;0&#46;68 <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; the results above concordance between imputed PaO2&#47;FiO2 and SpO2&#47;FiO2 with Bland&#8211;Altman graph&#44; and the validity for physiologic variable&#44; mechanical ventilation and radiological findings between SpO2&#47;FiO2 and severe Hypoxemia PaO2&#47;FiO2<span class="elsevierStyleHsp" style=""></span>&#60;&#61;<span class="elsevierStyleHsp" style=""></span>150 showed in <a class="elsevierStyleCrossRef" href="#sec0065">Supplementary Material</a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In a practical way and to establish the usefulness of SpO2&#47;FiO2 measurement&#44; we present the ranges of values between SpO2&#47;FiO2 and PaO2&#47;FiO2 imputed by the three methods and PaO2&#47;FiO2 measured by arterial gases in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study found an adequate correlation between PaO2&#47;FiO2 obtained by the three proposed imputation methods&#44; SpO2&#47;FiO2&#44; and PaO2&#47;FiO2 values obtained by arterial blood gases&#44; considering the usefulness of these tools as non-invasive methods for the assessment of the oxygenation status in patients with invasive ventilatory support&#46; We also found that the three imputation methods evaluated and the SpO2&#47;FiO2 have an adequate diagnostic performance for severe hypoxemia &#40;PaO2&#47;FiO2<span class="elsevierStyleHsp" style=""></span>&#60;&#61;<span class="elsevierStyleHsp" style=""></span>150<span class="elsevierStyleHsp" style=""></span>mmHg by arterial gases&#41; in patients living at high altitude&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">It was previously determined that the concordance between the different non-invasive oxygenation indexes and the PaO2&#47;FiO2 obtained by arterial gases is high<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">7&#44;16&#44;23&#44;24</span></a> Cineci and Gomez found an overall correlation index of 0&#46;745 between SpO2&#47;FiO2 and PaO2&#47;FiO2 in patients with ARF<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">11</span></a>&#59; Rice et al&#46; using imputation formulas&#44; report a correspondence range between 0&#46;73 and 0&#46;88<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;14&#44;15</span></a> that are similar to those observed in our study &#40;greater than 0&#46;77&#41;&#46; This accuracy can be influenced by the use of PEEP&#44; hemoglobin levels&#44; total bilirubin values&#44; by the determinants of the affinity of oxygen for hemoglobin &#40;pH&#44; temperature&#44; CO2&#44; 2&#46;3-diphosphoglycerate&#44; and fetal hemoglobin&#41;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;15</span></a> and extreme values of arterial saturation&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">6&#44;25</span></a> which can vary in critically-ill ventilated patients&#46; Our results show an important decrease in the correlation in subjects with hyperbilirubinemia &#40;total bilirubin &#8805;3<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41; and hemoglobin less than &#8804;7<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; without it being significantly affected by temperature&#44; vasoactive support&#44; and severity of multiorgan involvement&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Theoretically&#44; imputation techniques that simulate the hemoglobin dissociation curve have a better diagnostic yield with the patient&#39;s oxygenation status&#46; Brown&#39;s<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;13</span></a> and Gadrey&#39;s<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">24</span></a> studies found that the diagnosis of moderate-to-severe hypoxemia is better when non-linear formulas are used&#46; Despite this&#44; our data show similar performance among the different imputation methods&#44; without important changes in their diagnostic capacity when patients with arterial oxygen saturation greater than 97&#37; are included&#46; This difference is probably explained by the type of population studied and the barometric pressure to which our patients are exposed&#46; It is important to emphasize that our results are aimed at the recognition of severe hypoxemia and not hyperoxemia&#44; where the subrogated SpO2 values may be more limited&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">25</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Although mechanical ventilators represent a closed circuit&#44; there are not pressurized&#59; therefore&#44; patients ventilated at high altitude may have lower PaO2 and SaO2 values than those obtained at sea level&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">6&#44;26&#44;27</span></a> Previous observations show that the corresponding values of SaO2&#47;FiO2 from 214 to 235 are equivalent to a PaO2&#47;FiO2 &#40;for arterial gases&#41; of 200 in inhabitants of low-altitude areas&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">11&#44;15</span></a> However&#44; there are no studies in patients under invasive mechanical ventilation living at more than 1500<span class="elsevierStyleHsp" style=""></span>m a&#46;s&#46;l&#46; that establish a single SpO2&#47;FiO2 value corresponding to a given PaO2&#47;FiO2&#46; This limitation also affects the values obtained by imputation methods&#44; since it is not possible to establish values that correspond to these measurements without any margin of error&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> Considering these difficulties&#44; we propose a table of equivalence between SpO2&#47;FiO2 ranges and PaO2&#47;FiO2 values imputed by the three methods and that obtained by arterial gases&#44; to establish values for the diagnosis and follow-up of patients with different degrees of hypoxemia that may be useful in clinical practice&#46; We must not forget to evaluate these considering medical criteria and the condition of the patient&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">We acknowledge that our study has certain limitations&#46; First&#44; a single arterial gas sampling was performed&#44; which can affect the reliability of the measured values of the quantitative variables for the diagnosis of hypoxemia and the appearance of random errors&#46; However&#44; the samples were taken by trained personnel and keeping all the recommendations for adequate processing in the laboratory&#46; Second&#44; some data were collected retrospectively&#44; which can generate an information bias&#59; however&#44; we verified that the values obtained from the clinical histories corresponded to the data reported directly by the laboratory&#46; Third&#44; despite having a large population living at high altitude&#44; our sample does not include all possible altitudes&#59; but we consider that it is unlikely that there are significant differences in the reliability of the formulas&#46; Fourth&#44; SpO2 values can be affected by methemoglobin and carboxyhemoglobin levels&#44; which were not measured in the study&#46; Despite this&#44; none of the patients were suspected to have these disorders&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; the present study found that at high altitude SaO2&#47;FiO2 and imputed PaO2&#47;FiO2 have a similar diagnostic yield in patients with severe hypoxemia&#44; ventilated for various pathological conditions&#46; Equivalence ranges between SaO2&#47;FiO2 and PaO2&#47;FiO2 values can be a non-invasive option in the follow-up of these subjects&#46; It is necessary to develop additional prospective studies&#44; where therapeutic goals of SpO2&#47;FiO2 and imputed PaO2&#47;FiO2 are explored to corroborate the safety ranges of these measurements&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Funding</span><p id="par0115" class="elsevierStylePara elsevierViewall">The author received no financial support for the research&#44; authorship&#44; and&#47;or publication of this article</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Author contributions</span><p id="par0120" class="elsevierStylePara elsevierViewall">GO&#44; AB&#44; MB&#44; MGF and AL had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis&#46; GO&#44; AB&#44; MB&#44; MGF&#44; AL&#44; GD&#44; JO contributed substantially to the study design&#44; data analysis and interpretation&#44; and the writing of the manuscript&#46; GO&#44; AB contributed substantially to data statistical analysis&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Conflict of interests</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors of this manuscript have no competing interests directly related to the manuscript&#39;s content&#46;</p></span></span>"
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            0 => "ARI"
            1 => "ARDS"
            2 => "AUC-ROC"
            3 => "CI"
            4 => "ICC"
            5 => "FiO2"
            6 => "MSNM"
            7 => "PaCO2"
            8 => "PaO2"
            9 => "PEEP"
            10 => "SOFA"
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        0 => array:4 [
          "clase" => "keyword"
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          "identificador" => "xpalclavsec1550993"
          "palabras" => array:5 [
            0 => "Ventilaci&#243;n mec&#225;nica"
            1 => "SaO2&#47;FiO2"
            2 => "PaO2&#47;FiO2"
            3 => "Insuficiencia respiratoria"
            4 => "Altitud elevada"
          ]
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To establish the correlation and validity between PaO2&#47;FiO2 obtained on arterial gases versus noninvasive methods &#40;linear&#44; nonlinear&#44; logarithmic imputation of PaO2&#47;FiO2 and SpO2&#47;FiO2&#41; in patients under mechanical ventilation living at high altitude&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ambispective descriptive multicenter cohort study&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Two intensive care units &#40;ICU&#41; from Colombia at 2600<span class="elsevierStyleHsp" style=""></span>m a&#46;s&#46;l&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Patients or participants</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Consecutive critically ill patients older than 18 years with at least 24<span class="elsevierStyleHsp" style=""></span>h of mechanical ventilation were included from June 2016 to June 2019&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Interventions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">None&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Variables</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Variables analyzed were demographic&#44; physiological messures&#44; laboratory findings&#44; oxygenation index and clinical condition&#46; Nonlinear&#44; linear and logarithmic imputation formulas were used to calculate PaO2 from SpO2&#44; and at the same time the SpO2&#47;FiO2 by severe hypoxemia diagnosis&#46; The intraclass correlation coefficient&#44; area under the ROC curve&#44; sensitivity&#44; specificity&#44; positive predictive value&#44; negative predictive value&#44; positive and negative likelihood ratio were calculated&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The correlation between PaO2&#47;FiO2 obtained from arterial gases&#44; PaO2&#47;FiO2 derived from one of the proposed methods &#40;linear&#44; non-linear&#44; and logarithmic formula&#41;&#44; and SpO2&#47;FiO2 measured by the intraclass correlation coefficient was high &#40;greater than 0&#46;77&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The different imputation methods and SpO2&#47;FiO2 have a similar diagnostic performance in patients with severe hypoxemia &#40;PaO2&#47;FiO2 &#60;150&#41;&#46; PaO2&#47;FiO2 linear imputation AUC ROC 0&#44;84 &#40;IC 0&#46;81&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; PaO2&#47;FiO2 logarithmic imputation AUC ROC 0&#46;84 &#40;IC 0&#46;80&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; PaO2&#47;FiO2 non-linear imputation AUC ROC 0&#46;82 &#40;IC 0&#46;79&#8211;0&#46;85&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; SpO2&#47;FiO2 oximetry AUC ROC 0&#46;84 &#40;IC 0&#46;81&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">At high altitude&#44; the SaO2&#47;FiO2 ratio and the imputed PaO2&#47;FiO2 ratio have similar diagnostic performance in patients with severe hypoxemia ventilated by various pathological conditions&#46;</p></span>"
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            "titulo" => "Objective"
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            "titulo" => "Design"
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            "identificador" => "abst0015"
            "titulo" => "Setting"
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            "titulo" => "Patients or participants"
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            "titulo" => "Variables"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Establecer la correlaci&#243;n y validez entre PaO2&#47;FiO2 obtenida en gases arteriales versus m&#233;todos no invasivos &#40;imputaci&#243;n lineal&#44; no lineal&#44; logar&#237;tmica de PaO2&#47;FiO2 y SpO2&#47;FiO2&#41; en pacientes bajo ventilaci&#243;n mec&#225;nica que viven en altitudes elevadas&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohorte multic&#233;ntrico descriptivo ambispectivo</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Dos unidades de cuidados intensivos de Colombia a 2&#46;600 m s&#46;n&#46;m&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes o participantes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron pacientes consecutivos en estado cr&#237;tico mayores de 18 a&#241;os con al menos 24<span class="elsevierStyleHsp" style=""></span>h de ventilaci&#243;n mec&#225;nica desde junio de 2016 a junio de 2019&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Intervenciones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Ninguna&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Las variables analizadas fueron demogr&#225;ficas&#44; fisiol&#243;gicas&#44; hallazgos de laboratorio&#44; &#237;ndice de oxigenaci&#243;n y estado cl&#237;nico&#46; Se utilizaron f&#243;rmulas de imputaci&#243;n no lineales&#44; lineales y logar&#237;tmicas para calcular la PaO2 a partir de la SpO2&#44; y al mismo tiempo la SpO2&#47;FiO2 mediante el diagn&#243;stico de hipoxemia severa&#46; Se calcul&#243; el coeficiente de correlaci&#243;n intraclase&#44; el &#225;rea bajo la curva ROC&#44; la sensibilidad&#44; la especificidad&#44; el valor predictivo positivo&#44; el valor predictivo negativo&#44; la raz&#243;n de verosimilitud positiva y negativa&#46;</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">La correlaci&#243;n entre PaO2&#47;FiO2 obtenida a partir de gases arteriales&#44; PaO2&#47;FiO2 derivada de uno de los m&#233;todos propuestos &#40;f&#243;rmula lineal&#44; no lineal y logar&#237;tmica&#41; y SpO2&#47;FiO2 medida por el coeficiente de correlaci&#243;n intraclase fue alta &#40;mayor a 0&#44;77&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los diferentes m&#233;todos de imputaci&#243;n y SpO2&#47;FiO2 tienen un rendimiento diagn&#243;stico similar en pacientes con hipoxemia severa &#40;PaO2&#47;FiO2<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>150&#41;&#46; PaO2&#47;FiO2 imputaci&#243;n lineal AUC ROC 0&#44;84 &#40;IC 0&#44;81-0&#44;87&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; PaO2&#47;FiO2 imputaci&#243;n logar&#237;tmica AUC ROC 0&#44;84 &#40;IC 0&#44;80-0&#44;87&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; PaO2&#47;Imputaci&#243;n no lineal de FiO2 AUC ROC 0&#44;82 &#40;IC 0&#44;79-0&#44;85&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; oximetr&#237;a de SpO2&#47;FiO2 AUC ROC 0&#44;84 &#40;IC 0&#44;81-0&#44;87&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">A gran altitud&#44; el cociente SaO2&#47;FiO2 y el cociente PaO2&#47;FiO2 imputado tienen un rendimiento diagn&#243;stico similar en pacientes con hipoxemia severa bajo ventilaci&#243;n mec&#225;nica invasiva por diversas patolog&#237;as&#46;</p></span>"
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            "titulo" => "Dise&#241;o"
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          2 => array:2 [
            "identificador" => "abst0055"
            "titulo" => "&#193;mbito"
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          3 => array:2 [
            "identificador" => "abst0060"
            "titulo" => "Pacientes o participantes"
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            "titulo" => "Intervenciones"
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            "titulo" => "Variables"
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            "titulo" => "Resultados"
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            "apendice" => "<p id="par0135" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0070"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">ROC curve with yield of PaO2&#47;FiO2 imputed by the three methods of imputation and SpO2&#47;FiO2&#46;</p> <p id="spar0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Notes</span>&#58; AUC-ROC&#58; area under the ROC-curve&#44; PaO2&#47;FiO2 linear imputation 0&#46;84 &#40;95&#37;CI&#58; 0&#46;81&#8211;0&#46;87&#41;&#59; PaO2&#47;FiO2 logarithmic imputation 0&#46;84 &#40;95&#37;CI&#58; 0&#46;80&#8211;0&#46;87&#41;&#59; PaO2&#47;FiO2 non-linear 0&#46;82 &#40;95&#37;CI&#58; 0&#46;79&#8211;0&#46;85&#41;&#59; SO2&#47;FiO2 pulse oximetry 0&#46;84 &#40;95&#37;CI&#58; 0&#46;81&#8211;0&#46;87&#41;&#46;</p>"
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        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Notes</span>&#58; SD&#58; standard deviation&#44; SBP&#58; systolic blood pressure&#44; DBP&#58; diastolic blood pressure&#44; MAP&#58; mean arterial pressure&#44; HR&#58; heart rate&#44; RR&#58; respiratory rate&#44; Hb&#58; hemoglobin&#44; SOFA&#58; Sepsis-related Organ Failure Assessment&#44; IQR&#58; interquartile range&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Elective surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;272&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Emergency surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">75&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;0&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">49&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;0&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">26&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;0&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-surgical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">535&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">348&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;0&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">187&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Height cm &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">163&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;9&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">162&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;9&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">163&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;876&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Weight kg &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;157&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;12&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;12&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;493&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Vital signs &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">87&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;18&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;17&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;862&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">SBP mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">119&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;24&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">119&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;24&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">119&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;23&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;856&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">DBP mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;17&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;17&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;16&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;493&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">MAP mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;18&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">87&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Leukocytes cell&#47;ml&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Platelet count cell&#47;ml&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total bilirubin &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinine &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;376&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">General characteristics of the cohort&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Notes</span>&#58; SENS&#58; sensitivity&#59; SPEC&#58; specificity&#59; AUC-ROC&#58; area under the ROC curve&#59; PPV&#58; positive predictive values&#59; NPV&#58; negative predictive values&#59; LR&#58; likelihood ratio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Method&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AUC-ROC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CI 95&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PPV&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">NPV&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LR&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LR-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">PaO2 linear imputation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;0&#46;80&#44; 0&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">73&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO2 logarithmic imputation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;0&#46;81&#44; 0&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">50&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">3&#46;71&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO2 non-linear imputation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#40;0&#46;55&#44; 0&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">70&#46;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;40&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">PaO2&#47;FiO2 linear imputation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO2&#47;FiO2 logarithmic imputation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;0&#46;80&#44; 0&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
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                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Results of validity between the formulas of imputation of PaO2&#44; PaO2&#47;FiO2&#44; SpO2&#47;FiO2 and PaO2&#44; PaO2&#47;FiO2 of arterial blood gases and severe Hypoxemia PaO2&#47;FiO2<span class="elsevierStyleHsp" style=""></span>&#60;&#61;<span class="elsevierStyleHsp" style=""></span>150&#46;</p>"
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Original article
Correlation and validity of imputed PaO2/FiO2 and SpO2/FiO2 in patients with invasive mechanical ventilation at 2600m above sea level
Correlación y validez de la PaO2/FiO2 y SpO2/FiO2 imputadas en pacientes con ventilación mecánica invasiva a 2.600 metros sobre el nivel del mar
G. Ortiza, A. Bastidasb,
Autor para correspondencia
, M. Garay-Fernándezc, A. Larac, M. Benavidesc, E. Rochad, A. Buitragoc, G. Díazc, J. Ordóñezc, L.F. Reyesb
a Pulmonary Medicine, Universidad El Bosque, Intensive Care Unit, Hospital Santa Clara Bogotá, Colombia
b School of Medicine, Universidad de la Sabana, Clínica Universidad de La Sabana, Chía, Colombia
c Pulmonary Medicine Universidad El Bosque, Intensive Care Unit, Hospital Santa Clara Bogotá, Colombia
d Intensive Care Unit, Hospital Santa Clara Bogotá, Colombia
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such as in the sequential multiple organ damage assessment &#40;SOFA&#41; scale&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The measurement of arterial blood gases is required to determine PaO2 and calculate the PaO2&#47;FiO2 ratio&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">5&#44;6</span></a> However&#44; this technique can present limitations in its use&#44; either because of difficulty in taking the sample &#40;either because it requires trained personnel&#44; complicated arterial accesses&#44; constant puncture requirements&#44; pain at the time of sample collection and skin laceration&#41; or because it represents an increase in hospital costs&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A non-invasive substitute for the PaO2&#47;FiO2 ratio is the ratio of the percentage of hemoglobin saturation measured by pulse oximetry &#40;SpO2&#41; and the inspired fraction of oxygen &#40;FIO2&#41; &#40;SpO2&#47;FiO2&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">9</span></a> That allows the assessment and classification of the severity of respiratory failure<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">10</span></a> without the need for arterial blood sampling&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">11</span></a> Other methods have been proposed to estimate PaO2 without direct measurement of oxygen in arterial blood&#46; These models ensure their equivalence by imputing PaO2 from SpO2&#46; These imputation techniques can be classified into those that simulate the hemoglobin dissociation curve &#40;non-linear&#41;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;13</span></a> and those that take into account other types of relationships &#40;linear and logarithmic&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">14&#44;15</span></a> The studies that have compared these formulas show an adequate relationship between measured and imputed PaO2 values&#44; with high correlation coefficients ranging from 0&#46;75 to 0&#46;9&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;13&#44;15</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It must be taken into account that about 140 million people live at high altitudes &#40;over 2500<span class="elsevierStyleHsp" style=""></span>m above sea level&#41;&#44; which is why it is essential to understand how the oxygenation indices &#40;PaO2&#47;FiO2 and SpO2&#47;FiO2&#41; behave in these regions&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">16</span></a> However&#44; we do not know of previous studies conducted in populations living at altitudes above 1500<span class="elsevierStyleHsp" style=""></span>m a&#46;s&#46;l&#46;&#44; which evaluate the performance of different imputation methods and SpO2&#47;FiO2 for the diagnosis of severe hypoxemia&#46; Therefore&#44; we aimed to establish the correlation and validity between PaO2&#47;FiO2 obtained in arterial gases vs&#46; non-invasive methods &#40;linear&#44; non-linear&#44; logarithmic imputation of PaO2&#47;FiO2 and SpO2&#47;FiO2&#41; in patients living at 2600 a&#46;s&#46;l&#46; and under invasive mechanical ventilation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Methodology</span><p id="par0025" class="elsevierStylePara elsevierViewall">Ambispective cohort study was conducted in patients hospitalized in intensive care units with invasive ventilatory support in two third-level care hospitals in Colombia&#44; the Santa Clara Hospital in the city of Bogota &#40;Altitude&#58; 2640<span class="elsevierStyleHsp" style=""></span>m above sea level&#41; and the Cl&#237;nica Universidad de La Sabana in the city of Chia &#40;Altitude&#58; 2562<span class="elsevierStyleHsp" style=""></span>m above sea level&#41;&#46; The data was initially collected retrospectively&#44; from June 2016 to April 2019&#44; and prospectively from April to June 2019&#59; 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sex&#44; skin pigmentation&#44; type of pathology of entry&#44; weight&#44; height&#44; vital signs&#44; values of hemoglobin&#44; hematocrit&#44; bilirubin&#44; and creatinine&#44; findings on chest radiography&#44; with verification of the presence of infiltrates and the number of quadrants involved&#44; SOFA severity score&#44; vasopressor support&#44; ventilatory support parameters &#40;PEEP level &#62;10 and &#60;10<span class="elsevierStyleHsp" style=""></span>cmH20&#44;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">17&#44;18</span></a> peak pressure&#44; plateau pressure&#44; tidal volume&#41;&#44; total arterial gas values and oxygenation rates&#44; days of mechanical ventilation&#44; intensive care unit &#40;ICU&#41; and hospital stays&#46; Severe hypoxemia was the value of the PaO2&#47;FiO2 ratio obtained from arterial gases less than 150&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">19&#44;20</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Severingaus-Ellis&#40;no linear&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">21&#44;22</span></a> Rice &#40;linear&#41;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">14</span></a> and Pandharipande &#40;logarithmic linear&#41;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">15</span></a> formulas were used to calculate imputed PaO2 from SpO2&#46; The values of imputed PaO2 were used for the calculation of imputed PaO2&#47;FiO2&#59; besides&#44; SpO2&#47;FiO2 was calculated simultaneously&#46; The blood sample for arterial gases analysis was obtained through an arterial line&#59; the oximeters used measure the saturation through an infrared sensor with a wavelength of 905<span class="elsevierStyleHsp" style=""></span>nm 2&#46;0<span class="elsevierStyleHsp" style=""></span>mW with an error range of 1&#37;&#59; verification and calibration were performed daily during the study&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">All the subjects admitted to the ICU of both institutions during the study period were included&#46; In order to reduce errors in data collection and transcription&#44; the data were recorded by double typing and reviewed by two members of the research team&#46; This protocol was approved by the ethics committee of the Cl&#237;nica Universidad de La Sabana&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">An initial descriptive analysis was carried out&#44; summarizing the qualitative variables in frequencies and percentages&#44; the quantitative variables with normal distribution in means and standard deviation and if they did not meet the criteria of normality in medians and interquartile ranges&#46; The qualitative variables were compared through the chi-square test and the quantitative ones with Student&#39;s t-test or Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test according to their distribution&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">We applied the intraclass correlation coefficient between the values obtained from imputed PaO2&#44; PaO2&#47;FiO2 derived from the imputation methods&#44; and the SpO2&#47;FiO2 with the PaO2&#47;FiO2 of the arterial gases&#46; We considered the correlations thus&#58; 0&#8211;0&#46;3 null&#59; 0&#46;31&#8211;0&#46;50 low&#59; 0&#46;51&#8211;0&#46;70 moderate&#59; 0&#46;76&#8211;1&#46;00 strong&#46; The Bland&#8211;Altman method was used to evaluate the concordance&#46; For the validity&#44; the area under the ROC curve of the quantitative values obtained through the three imputation methods and the SpO2&#47;FiO2 value was calculated&#44; comparing it with the value of the arterial gases of severe hypoxemia &#40;PaO2&#47;FiO2<span class="elsevierStyleHsp" style=""></span>&#60;&#61;<span class="elsevierStyleHsp" style=""></span>150&#41;&#44; to obtain the best cut-off point using the Youden index and calculating the values of sensitivity&#44; specificity&#44; positive predictive value &#40;PPV&#41;&#44; negative predictive value &#40;NPV&#41;&#44; positive and negative likelihood ratio&#46; The ROC area was also used to establish the equivalence ranges between the different SpO2&#47;FiO2 measurements&#46; A <span class="elsevierStyleItalic">p</span>-value of less than 0&#46;05 was considered significant&#46; The statistical analysis was performed with the SPSS 22&#46;0 licensed program &#40;Statistical Package for the Social Sciences&#44; Chicago&#44; IL&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">We included a total of 664 patients during the study period&#44; the general characteristics of the patients were described according to positive end-expiratory pressures &#40;PEEP&#41; greater or less than 10<span class="elsevierStyleHsp" style=""></span>cm H2O and are showed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Among the general characteristics&#44; it was found that the patients had an mean age of 56<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20 years&#44; with a male predominance 444&#47;664 &#40;67&#37;&#41;&#44; most of the pathological conditions on admission were non-surgical &#40;81&#37;&#41;&#44; the mean SOFA was 15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2 points&#44; and 56&#37; of the patients required vasoactive support&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Arterial gases and mechanical ventilation</span><p id="par0065" class="elsevierStylePara elsevierViewall">The mean PaO2 was 83&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;5<span class="elsevierStyleHsp" style=""></span>mmHg&#44; SpO2 92&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;3&#37;&#44; PaCO2 33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;9<span class="elsevierStyleHsp" style=""></span>mmHg&#44; and bicarbonate 21&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6<span class="elsevierStyleHsp" style=""></span>mEq&#47;L&#44; with no significant differences between subgroups&#46; The pH was 7&#46;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;11 and the base excess &#8722;1&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4<span class="elsevierStyleHsp" style=""></span>mEq&#47;L&#46; The ventilatory parameters were a tidal volume of 481<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>58&#46;3<span class="elsevierStyleHsp" style=""></span>ml&#44; FIO2 of 50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>19&#37;&#44; plateau pressure 19&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;3<span class="elsevierStyleHsp" style=""></span>cmH2O&#44; and driving pressure of 10&#46;8<span class="elsevierStyleHsp" style=""></span>cmH2O&#46; The mean time of mechanical ventilation was 7&#46;1 days&#44; ICU length of stay was 10&#46;4 days and overall mortality was 18&#37;&#46; &#40;<a class="elsevierStyleCrossRef" href="#sec0065">Supplementary Material</a>&#41;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Correlation and validity results</span><p id="par0070" class="elsevierStylePara elsevierViewall">The correlation between PaO2&#47;FiO2 obtained from arterial gases&#44; PaO2&#47;FiO2 derived from one of the proposed methods &#40;linear&#44; non-linear&#44; and logarithmic formula&#41;&#44; and SpO2&#47;FiO2 measured by the intraclass correlation coefficient was high &#40;greater than 0&#46;77&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The different imputation methods and SpO2&#47;FiO2 have a similar diagnostic performance in patients with severe hypoxemia &#40;PaO2&#47;FiO2 &#60;150&#41;&#44; with an area under the ROC curve greater than 0&#46;8 with a similar sensitivity and specificity&#44; PaO2&#47;FiO2 linear imputation AUC ROC 0&#46;84 &#40;IC 0&#46;81&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; PaO2&#47;FiO2 logarithmic imputation AUC ROC 0&#46;84 &#40;IC 0&#46;80&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; PaO2&#47;FiO2 non-linear imputation AUC ROC 0&#46;82 &#40;IC 0&#46;79&#8211;0&#46;85&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; SpO2&#47;FiO2 oximetry AUC ROC 0&#46;84 &#40;IC 0&#46;81&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> and <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">We found that the correlation of the different methods applied &#40;imputation and SpO2&#47;FIO2&#41; decreased with hemoglobin levels equal to or less than 7<span class="elsevierStyleHsp" style=""></span>g&#47;dl &#40;0&#46;58 <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; as well as with total bilirubin values equal to or greater than 3<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;0&#46;68 <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; the results above concordance between imputed PaO2&#47;FiO2 and SpO2&#47;FiO2 with Bland&#8211;Altman graph&#44; and the validity for physiologic variable&#44; mechanical ventilation and radiological findings between SpO2&#47;FiO2 and severe Hypoxemia PaO2&#47;FiO2<span class="elsevierStyleHsp" style=""></span>&#60;&#61;<span class="elsevierStyleHsp" style=""></span>150 showed in <a class="elsevierStyleCrossRef" href="#sec0065">Supplementary Material</a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In a practical way and to establish the usefulness of SpO2&#47;FiO2 measurement&#44; we present the ranges of values between SpO2&#47;FiO2 and PaO2&#47;FiO2 imputed by the three methods and PaO2&#47;FiO2 measured by arterial gases in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study found an adequate correlation between PaO2&#47;FiO2 obtained by the three proposed imputation methods&#44; SpO2&#47;FiO2&#44; and PaO2&#47;FiO2 values obtained by arterial blood gases&#44; considering the usefulness of these tools as non-invasive methods for the assessment of the oxygenation status in patients with invasive ventilatory support&#46; We also found that the three imputation methods evaluated and the SpO2&#47;FiO2 have an adequate diagnostic performance for severe hypoxemia &#40;PaO2&#47;FiO2<span class="elsevierStyleHsp" style=""></span>&#60;&#61;<span class="elsevierStyleHsp" style=""></span>150<span class="elsevierStyleHsp" style=""></span>mmHg by arterial gases&#41; in patients living at high altitude&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">It was previously determined that the concordance between the different non-invasive oxygenation indexes and the PaO2&#47;FiO2 obtained by arterial gases is high<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">7&#44;16&#44;23&#44;24</span></a> Cineci and Gomez found an overall correlation index of 0&#46;745 between SpO2&#47;FiO2 and PaO2&#47;FiO2 in patients with ARF<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">11</span></a>&#59; Rice et al&#46; using imputation formulas&#44; report a correspondence range between 0&#46;73 and 0&#46;88<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;14&#44;15</span></a> that are similar to those observed in our study &#40;greater than 0&#46;77&#41;&#46; This accuracy can be influenced by the use of PEEP&#44; hemoglobin levels&#44; total bilirubin values&#44; by the determinants of the affinity of oxygen for hemoglobin &#40;pH&#44; temperature&#44; CO2&#44; 2&#46;3-diphosphoglycerate&#44; and fetal hemoglobin&#41;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;15</span></a> and extreme values of arterial saturation&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">6&#44;25</span></a> which can vary in critically-ill ventilated patients&#46; Our results show an important decrease in the correlation in subjects with hyperbilirubinemia &#40;total bilirubin &#8805;3<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41; and hemoglobin less than &#8804;7<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; without it being significantly affected by temperature&#44; vasoactive support&#44; and severity of multiorgan involvement&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Theoretically&#44; imputation techniques that simulate the hemoglobin dissociation curve have a better diagnostic yield with the patient&#39;s oxygenation status&#46; Brown&#39;s<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;13</span></a> and Gadrey&#39;s<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">24</span></a> studies found that the diagnosis of moderate-to-severe hypoxemia is better when non-linear formulas are used&#46; Despite this&#44; our data show similar performance among the different imputation methods&#44; without important changes in their diagnostic capacity when patients with arterial oxygen saturation greater than 97&#37; are included&#46; This difference is probably explained by the type of population studied and the barometric pressure to which our patients are exposed&#46; It is important to emphasize that our results are aimed at the recognition of severe hypoxemia and not hyperoxemia&#44; where the subrogated SpO2 values may be more limited&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">25</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Although mechanical ventilators represent a closed circuit&#44; there are not pressurized&#59; therefore&#44; patients ventilated at high altitude may have lower PaO2 and SaO2 values than those obtained at sea level&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">6&#44;26&#44;27</span></a> Previous observations show that the corresponding values of SaO2&#47;FiO2 from 214 to 235 are equivalent to a PaO2&#47;FiO2 &#40;for arterial gases&#41; of 200 in inhabitants of low-altitude areas&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">11&#44;15</span></a> However&#44; there are no studies in patients under invasive mechanical ventilation living at more than 1500<span class="elsevierStyleHsp" style=""></span>m a&#46;s&#46;l&#46; that establish a single SpO2&#47;FiO2 value corresponding to a given PaO2&#47;FiO2&#46; This limitation also affects the values obtained by imputation methods&#44; since it is not possible to establish values that correspond to these measurements without any margin of error&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">13</span></a> Considering these difficulties&#44; we propose a table of equivalence between SpO2&#47;FiO2 ranges and PaO2&#47;FiO2 values imputed by the three methods and that obtained by arterial gases&#44; to establish values for the diagnosis and follow-up of patients with different degrees of hypoxemia that may be useful in clinical practice&#46; We must not forget to evaluate these considering medical criteria and the condition of the patient&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">We acknowledge that our study has certain limitations&#46; First&#44; a single arterial gas sampling was performed&#44; which can affect the reliability of the measured values of the quantitative variables for the diagnosis of hypoxemia and the appearance of random errors&#46; However&#44; the samples were taken by trained personnel and keeping all the recommendations for adequate processing in the laboratory&#46; Second&#44; some data were collected retrospectively&#44; which can generate an information bias&#59; however&#44; we verified that the values obtained from the clinical histories corresponded to the data reported directly by the laboratory&#46; Third&#44; despite having a large population living at high altitude&#44; our sample does not include all possible altitudes&#59; but we consider that it is unlikely that there are significant differences in the reliability of the formulas&#46; Fourth&#44; SpO2 values can be affected by methemoglobin and carboxyhemoglobin levels&#44; which were not measured in the study&#46; Despite this&#44; none of the patients were suspected to have these disorders&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; the present study found that at high altitude SaO2&#47;FiO2 and imputed PaO2&#47;FiO2 have a similar diagnostic yield in patients with severe hypoxemia&#44; ventilated for various pathological conditions&#46; Equivalence ranges between SaO2&#47;FiO2 and PaO2&#47;FiO2 values can be a non-invasive option in the follow-up of these subjects&#46; It is necessary to develop additional prospective studies&#44; where therapeutic goals of SpO2&#47;FiO2 and imputed PaO2&#47;FiO2 are explored to corroborate the safety ranges of these measurements&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Funding</span><p id="par0115" class="elsevierStylePara elsevierViewall">The author received no financial support for the research&#44; authorship&#44; and&#47;or publication of this article</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Author contributions</span><p id="par0120" class="elsevierStylePara elsevierViewall">GO&#44; AB&#44; MB&#44; MGF and AL had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis&#46; GO&#44; AB&#44; MB&#44; MGF&#44; AL&#44; GD&#44; JO contributed substantially to the study design&#44; data analysis and interpretation&#44; and the writing of the manuscript&#46; GO&#44; AB contributed substantially to data statistical analysis&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Conflict of interests</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors of this manuscript have no competing interests directly related to the manuscript&#39;s content&#46;</p></span></span>"
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    "fechaRecibido" => "2021-02-06"
    "fechaAceptado" => "2021-05-04"
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            0 => "Mechanical ventilation"
            1 => "SaO2&#47;FiO2"
            2 => "PaO2&#47;FiO2"
            3 => "Respiratory failure"
            4 => "High altitude"
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          "clase" => "abr"
          "titulo" => "Abbreviations"
          "identificador" => "xpalclavsec1550992"
          "palabras" => array:11 [
            0 => "ARI"
            1 => "ARDS"
            2 => "AUC-ROC"
            3 => "CI"
            4 => "ICC"
            5 => "FiO2"
            6 => "MSNM"
            7 => "PaCO2"
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            3 => "Insuficiencia respiratoria"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To establish the correlation and validity between PaO2&#47;FiO2 obtained on arterial gases versus noninvasive methods &#40;linear&#44; nonlinear&#44; logarithmic imputation of PaO2&#47;FiO2 and SpO2&#47;FiO2&#41; in patients under mechanical ventilation living at high altitude&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ambispective descriptive multicenter cohort study&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Two intensive care units &#40;ICU&#41; from Colombia at 2600<span class="elsevierStyleHsp" style=""></span>m a&#46;s&#46;l&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Patients or participants</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Consecutive critically ill patients older than 18 years with at least 24<span class="elsevierStyleHsp" style=""></span>h of mechanical ventilation were included from June 2016 to June 2019&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Interventions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">None&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Variables</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Variables analyzed were demographic&#44; physiological messures&#44; laboratory findings&#44; oxygenation index and clinical condition&#46; Nonlinear&#44; linear and logarithmic imputation formulas were used to calculate PaO2 from SpO2&#44; and at the same time the SpO2&#47;FiO2 by severe hypoxemia diagnosis&#46; The intraclass correlation coefficient&#44; area under the ROC curve&#44; sensitivity&#44; specificity&#44; positive predictive value&#44; negative predictive value&#44; positive and negative likelihood ratio were calculated&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The correlation between PaO2&#47;FiO2 obtained from arterial gases&#44; PaO2&#47;FiO2 derived from one of the proposed methods &#40;linear&#44; non-linear&#44; and logarithmic formula&#41;&#44; and SpO2&#47;FiO2 measured by the intraclass correlation coefficient was high &#40;greater than 0&#46;77&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The different imputation methods and SpO2&#47;FiO2 have a similar diagnostic performance in patients with severe hypoxemia &#40;PaO2&#47;FiO2 &#60;150&#41;&#46; PaO2&#47;FiO2 linear imputation AUC ROC 0&#44;84 &#40;IC 0&#46;81&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; PaO2&#47;FiO2 logarithmic imputation AUC ROC 0&#46;84 &#40;IC 0&#46;80&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; PaO2&#47;FiO2 non-linear imputation AUC ROC 0&#46;82 &#40;IC 0&#46;79&#8211;0&#46;85&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; SpO2&#47;FiO2 oximetry AUC ROC 0&#46;84 &#40;IC 0&#46;81&#8211;0&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">At high altitude&#44; the SaO2&#47;FiO2 ratio and the imputed PaO2&#47;FiO2 ratio have similar diagnostic performance in patients with severe hypoxemia ventilated by various pathological conditions&#46;</p></span>"
        "secciones" => array:8 [
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            "titulo" => "Objective"
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            "titulo" => "Design"
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            "identificador" => "abst0015"
            "titulo" => "Setting"
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            "titulo" => "Patients or participants"
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            "titulo" => "Interventions"
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            "titulo" => "Variables"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Establecer la correlaci&#243;n y validez entre PaO2&#47;FiO2 obtenida en gases arteriales versus m&#233;todos no invasivos &#40;imputaci&#243;n lineal&#44; no lineal&#44; logar&#237;tmica de PaO2&#47;FiO2 y SpO2&#47;FiO2&#41; en pacientes bajo ventilaci&#243;n mec&#225;nica que viven en altitudes elevadas&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohorte multic&#233;ntrico descriptivo ambispectivo</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Dos unidades de cuidados intensivos de Colombia a 2&#46;600 m s&#46;n&#46;m&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes o participantes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron pacientes consecutivos en estado cr&#237;tico mayores de 18 a&#241;os con al menos 24<span class="elsevierStyleHsp" style=""></span>h de ventilaci&#243;n mec&#225;nica desde junio de 2016 a junio de 2019&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Intervenciones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Ninguna&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Las variables analizadas fueron demogr&#225;ficas&#44; fisiol&#243;gicas&#44; hallazgos de laboratorio&#44; &#237;ndice de oxigenaci&#243;n y estado cl&#237;nico&#46; Se utilizaron f&#243;rmulas de imputaci&#243;n no lineales&#44; lineales y logar&#237;tmicas para calcular la PaO2 a partir de la SpO2&#44; y al mismo tiempo la SpO2&#47;FiO2 mediante el diagn&#243;stico de hipoxemia severa&#46; Se calcul&#243; el coeficiente de correlaci&#243;n intraclase&#44; el &#225;rea bajo la curva ROC&#44; la sensibilidad&#44; la especificidad&#44; el valor predictivo positivo&#44; el valor predictivo negativo&#44; la raz&#243;n de verosimilitud positiva y negativa&#46;</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">La correlaci&#243;n entre PaO2&#47;FiO2 obtenida a partir de gases arteriales&#44; PaO2&#47;FiO2 derivada de uno de los m&#233;todos propuestos &#40;f&#243;rmula lineal&#44; no lineal y logar&#237;tmica&#41; y SpO2&#47;FiO2 medida por el coeficiente de correlaci&#243;n intraclase fue alta &#40;mayor a 0&#44;77&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los diferentes m&#233;todos de imputaci&#243;n y SpO2&#47;FiO2 tienen un rendimiento diagn&#243;stico similar en pacientes con hipoxemia severa &#40;PaO2&#47;FiO2<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>150&#41;&#46; PaO2&#47;FiO2 imputaci&#243;n lineal AUC ROC 0&#44;84 &#40;IC 0&#44;81-0&#44;87&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; PaO2&#47;FiO2 imputaci&#243;n logar&#237;tmica AUC ROC 0&#44;84 &#40;IC 0&#44;80-0&#44;87&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; PaO2&#47;Imputaci&#243;n no lineal de FiO2 AUC ROC 0&#44;82 &#40;IC 0&#44;79-0&#44;85&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; oximetr&#237;a de SpO2&#47;FiO2 AUC ROC 0&#44;84 &#40;IC 0&#44;81-0&#44;87&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">A gran altitud&#44; el cociente SaO2&#47;FiO2 y el cociente PaO2&#47;FiO2 imputado tienen un rendimiento diagn&#243;stico similar en pacientes con hipoxemia severa bajo ventilaci&#243;n mec&#225;nica invasiva por diversas patolog&#237;as&#46;</p></span>"
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          0 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Objetivo"
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            "titulo" => "Dise&#241;o"
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          2 => array:2 [
            "identificador" => "abst0055"
            "titulo" => "&#193;mbito"
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          3 => array:2 [
            "identificador" => "abst0060"
            "titulo" => "Pacientes o participantes"
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            "titulo" => "Intervenciones"
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            "titulo" => "Variables"
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            "titulo" => "Resultados"
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            "apendice" => "<p id="par0135" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0070"
          ]
        ]
      ]
    ]
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      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
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            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">ROC curve with yield of PaO2&#47;FiO2 imputed by the three methods of imputation and SpO2&#47;FiO2&#46;</p> <p id="spar0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Notes</span>&#58; AUC-ROC&#58; area under the ROC-curve&#44; PaO2&#47;FiO2 linear imputation 0&#46;84 &#40;95&#37;CI&#58; 0&#46;81&#8211;0&#46;87&#41;&#59; PaO2&#47;FiO2 logarithmic imputation 0&#46;84 &#40;95&#37;CI&#58; 0&#46;80&#8211;0&#46;87&#41;&#59; PaO2&#47;FiO2 non-linear 0&#46;82 &#40;95&#37;CI&#58; 0&#46;79&#8211;0&#46;85&#41;&#59; SO2&#47;FiO2 pulse oximetry 0&#46;84 &#40;95&#37;CI&#58; 0&#46;81&#8211;0&#46;87&#41;&#46;</p>"
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        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Notes</span>&#58; SD&#58; standard deviation&#44; SBP&#58; systolic blood pressure&#44; DBP&#58; diastolic blood pressure&#44; MAP&#58; mean arterial pressure&#44; HR&#58; heart rate&#44; RR&#58; respiratory rate&#44; Hb&#58; hemoglobin&#44; SOFA&#58; Sepsis-related Organ Failure Assessment&#44; IQR&#58; interquartile range&#46;</p>"
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                  \t\t\t\t">0&#46;272&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Emergency surgery&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-surgical&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">535&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">348&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">187&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="8" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Height cm &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">163&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;9&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">162&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;9&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">163&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;876&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Weight kg &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">66&#46;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;157&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">66&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">67&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;493&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Vital signs &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">87&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">87&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">87&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;17&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;862&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">SBP mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">119&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;24&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">119&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">119&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;23&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;856&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">DBP mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">71&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#40;17&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;17&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;16&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;493&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">MAP mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;18&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#40;17&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;862&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">HR beats</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#215;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">min</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total bilirubin &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinine &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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            "detalle" => "Table "
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          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Notes</span>&#58; SENS&#58; sensitivity&#59; SPEC&#58; specificity&#59; AUC-ROC&#58; area under the ROC curve&#59; PPV&#58; positive predictive values&#59; NPV&#58; negative predictive values&#59; LR&#58; likelihood ratio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Method&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AUC-ROC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CI 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cut-off point&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SENS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SPEC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PPV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">NPV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LR&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LR-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO2 linear imputation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;80&#44; 0&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO2 logarithmic imputation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;81&#44; 0&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO2 non-linear imputation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;55&#44; 0&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO2&#47;FiO2 linear imputation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;81&#44; 0&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">147&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO2&#47;FiO2 logarithmic imputation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;80&#44; 0&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">119&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO2&#47;FiO2 non-linear imputation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  """
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