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9. Response

Author

Valbuena, Valeria S.M., primary, Barbaro, Ryan P., additional, Claar, Dru, additional, Valley, Thomas S., additional, Dickson, Robert P., additional, Gay, Steven E., additional, Sjoding, Michael W., additional, and Iwashyna, Theodore J., additional

Published
2022
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14. Effect of Early High-Dose Vitamin D3 Repletion on Cognitive Outcomes in Critically Ill Adults

Author

Han, Jin H., primary, Ginde, Adit A., additional, Brown, Samuel M., additional, Baughman, Adrienne, additional, Collar, Erin M., additional, Ely, E. Wesley, additional, Gong, Michelle N., additional, Hope, Aluko A., additional, Hou, Peter C., additional, Hough, Catherine L., additional, Iwashyna, Theodore J., additional, Jackson, James C., additional, Khan, Akram, additional, Orun, Onur M., additional, Patel, Mayur B., additional, Raman, Rameela, additional, Rice, Todd W., additional, Ringwood, Nancy, additional, Semler, Matthew W., additional, Shapiro, Nathan I., additional, Talmor, Daniel S., additional, and Self, Wesley H., additional

Published
2021
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15. Racial Bias in Pulse Oximetry Measurement Among Patients About to Undergo Extracorporeal Membrane Oxygenation in 2019-2020: A Retrospective Cohort Study

Author

Valbuena, Valeria S.M., Barbaro, Ryan P., Claar, Dru, Valley, Thomas S., Dickson, Robert P., Gay, Steven E., Sjoding, Michael W., and Iwashyna, Theodore J.

Subjects
Adult, Oxygen, Extracorporeal Membrane Oxygenation, Racism, Predictive Value of Tests, Critical Care: Original Research, Prevalence, Humans, Oximetry, Hypoxia, Respiratory Insufficiency, Retrospective Studies
Abstract

BACKGROUND: Pulse oximeters may produce less accurate results in non-White patients. RESEARCH QUESTION: Do pulse oximeters detect arterial hypoxemia less effectively in Black, Hispanic, and/or Asian patients than in White patients in respiratory failure and about to undergo extracorporeal membrane oxygenation (ECMO)? STUDY DESIGN AND METHODS: Data on adult patients with respiratory failure readings 6 h before ECMO were provided by the Extracorporeal Life Support Organization registry. Data was collected from 324 centers between January 2019 and July 2020. Our primary analysis was of rates of occult hypoxemia—low arterial oxygen saturation (Sao(2) ≤ 88%) on arterial blood gas measurement despite a pulse oximetry reading in the range of 92% to 96%. RESULTS: The rate of pre-ECMO occult hypoxemia, that is, arterial oxygen saturation (Sao(2)) ≤ 88%, was 10.2% (95% CI, 6.2%-15.3%) for 186 White patients with peripheral oxygen saturation (Spo(2)) of 92% to 96%; 21.5% (95% CI, 11.3%-35.3%) for 51 Black patients (P = .031 vs White); 8.6% (95% CI, 3.2%-17.7%) for 70 Hispanic patients (P = .693 vs White); and 9.2% (95% CI, 3.5%-19.0%) for 65 Asian patients (P = .820 vs White). Black patients with respiratory failure had a statistically significantly higher risk of occult hypoxemia with an OR of 2.57 (95% CI, 1.12-5.92) compared with White patients (P = .026). The risk of occult hypoxemia for Hispanic and Asian patients was equivalent to that of White patients. In a secondary analysis of patients with Sao(2) ≤ 88% despite Spo(2) > 96%, Black patients had more than three times the risk compared with White patients (OR, 3.52; 95% CI, 1.12-11.10; P = .032). INTERPRETATION: Compared with White patients, the prevalence of occult hypoxemia was higher in Black patients than in White patients about to undergo ECMO for respiratory failure, but it was comparable in Hispanic and Asian patients compared with White patients.

Published
2021

22. Response

Author

Sjoding, Michael W., primary and Iwashyna, Theodore J., additional

Published
2018
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24. Uncharted Paths

Author

Iwashyna, Theodore J., primary, Christie, Jason D., additional, Kahn, Jeremy M., additional, and Asch, David A., additional

Published
2009
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25. Response.

Author

Netzer, Giora, Shah, Chirag V., Iwashyna, Theodore J., Lanken, Paul N., Finkel, Barbara, Fuchs, Barry, and Christie, Jason D.

Subjects
LETTERS to the editor, LUNG injuries
Abstract

A response by Giora Netzer and colleagues to a letter to the editor about their article, "Association of RBC transfusion with mortality in patients with acute lung injury," in the October 2007 issue, is presented.

Published
2008
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