Admission PaO2 and Mortality Among Pediatric ICU Patients and Critically Ill Subgroups
Back to course
Video Transcription
Video Summary
Asset Subtitle
Resuscitation, Quality and Patient Safety, Pediatrics, 2022
Asset Caption
INTRODUCTION: Studies analyzing the association between hyperoxia and mortality in critically ill pediatric patients and those admitted after cardiac arrest are conflicting and limited by small sample sizes. The aim of this study is to evaluate the association between PaO2 on admission to the pediatric ICU and mortality in a heterogeneous, multicenter cohort and among subgroups of critically ill patients. METHODS: A retrospective cohort study was conducted using data from Virtual Pediatric Systems (VPS) database. VPS is a clinical pediatric critical care database with over 135 participating hospitals in North America. All VPS patients 18 years or younger admitted between 2015 and 2019 with an admission PaO2 were included. Cardiac patients and those admitted to a cardiac ICU were excluded. Patients were stratified into 50-point PaO2 bins based on admission PaO2. Modified PIM3 scores were calculated for all patients by excluding the PaO2 term from the PIM3 equation. ICD-9, ICD-10 codes, VPS admission data and PRISM3 results were used to classify patients into the following diagnostic subgroups: trauma, head trauma, sepsis, renal failure, hemorrhagic shock, and those admitted after cardiac arrest (post-arrest).  RESULTS: 13,071 patient encounters were included with an overall mortality of 13.5%. The relationship between admission PaO2 and mortality demonstrated a U-shaped quadratic curve, with higher mortality seen in hypoxic (PaO2 < 50 mm Hg, mortality 28.5%) and hyperoxic (PaO2 > 300 mm Hg, mortality 25.4%) patients. This relationship persisted after adjustment for illness severity using modified PIM3 scores. Similarly, a quadratic relationship was demonstrated among trauma, head trauma, sepsis, renal failure and hemorrhagic shock patients. However, among the 1,500 post-arrest patients, there was no correlation between admission PaO2 and mortality, even after controlling for modified PIM3 scores.   CONCLUSIONS: In a large multicenter pediatric cohort, admission PaO2 demonstrates a clear U-shaped quadratic relationship with mortality.  The persistence of this quadratic relationship in some but not all diagnostic subgroups suggests the pathophysiology of certain disease states may modify the hyperoxia effect. Further studies are necessary to determine whether this association is causal or merely incidental.
Meta Tag
Content Type Presentation
Knowledge Area Resuscitation
Knowledge Area Quality and Patient Safety
Knowledge Area Pediatrics
Knowledge Level Advanced
Membership Level Select
Tag Cardiac Arrest
Tag Mortality
Tag Pediatrics
Tag Hypoxia
Tag Oxygenation
Tag Cardiopulmonary Resuscitation CPR
Year 2022
Kara Holton
PICU fellow
admission PaO2 levels
pediatric ICU patients


Society of Critical Care Medicine

500 Midway Drive
Mount Prospect, IL 60056 USA

Phone: +1 847 827-6888
Fax: +1 847 439-7226

Contact Us

About SCCM


Advertising & Sponsorship




Patients & Families

Surviving Sepsis Campaign

Critical Care Societies Collaborative

kisspng-facebook-social-media-computer-icons-linkedin-soci-gray-5ac493cf1c2975.7867418415228323351154  - KW Symphony    Gray twitter 3 icon - Free gray social icons    Gray linkedin 3 icon - Free gray site logo icons    Gray instagram icon - Free gray social icons    YouTube Icon Gray Box - HONOR VETERANS NOW


© Society of Critical Care Medicine. All rights reserved.   |    Privacy Statement    |    Terms & Conditions
The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.

Android App Download IOS App Download Powered By