Association between oxygen debt (DEOx) variability over time and clinical outcomes in critically ill COVID-19 patients: an observational study
Abstract Background Oxygen debt (DEOx) quantifies oxygen deficit during shock, reflecting the transition to anaerobic metabolism due to decreased oxygen delivery (DO₂). This study aimed to analyze the temporal variation of DEOx values and their association with invasive mechanical ventilation (IMV)...
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BMC
2025-08-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-025-03858-9 |
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| author | Eduardo Tuta-Quintero Alirio Bastidas-Goyes Henry Robayo-Amortegui Michel Pérez-Garzón Isacio Serna-Palacios Cristian Peña-Quimbayo Julian Espitia Daniel Pinto Johan Rincón Juan Sánchez Jesus Pérez |
| author_facet | Eduardo Tuta-Quintero Alirio Bastidas-Goyes Henry Robayo-Amortegui Michel Pérez-Garzón Isacio Serna-Palacios Cristian Peña-Quimbayo Julian Espitia Daniel Pinto Johan Rincón Juan Sánchez Jesus Pérez |
| author_sort | Eduardo Tuta-Quintero |
| collection | DOAJ |
| description | Abstract Background Oxygen debt (DEOx) quantifies oxygen deficit during shock, reflecting the transition to anaerobic metabolism due to decreased oxygen delivery (DO₂). This study aimed to analyze the temporal variation of DEOx values and their association with invasive mechanical ventilation (IMV) requirement and survival in patients with severe COVID-19. Methods We conducted a retrospective cohort study including adult patients admitted to the ICU with confirmed SARS-CoV-2 infection at Clínica Universidad de La Sabana (Colombia) between July 2020 and December 2021. DEOx was calculated using two validated formulas: one based on lactate (DEOx1) and another incorporating lactate and base excess (DEOx2). Variability in DEOx was assessed at different time points (≤6h, 6-12h, 12-24h, >24h) and its association with IMV and survival outcomes was analyzed. Results A total of 597 patients were included, of whom 150 (25.1%) died. DEOx1 within 6 hours was -6.87 (SD: 23.72) in patients requiring IMV by day 7, compared to -1.2 (SD: 7.83) in patients without IMV (p=0.004). DEOx2 within 6 hours on day 7 was -7.92 (SD: 30.7) vs. -1.57 (SD: 14.65) (p=0.027), and between 6 and 12 hours, it was 1.24 (SD: 14.92) vs. -3.54 (SD: 9.34) (p<0.001). 24 hours (SD: 36.09) in deceased patients on day 7, compared to -2.09 (SD: 14.26) in survivors (p<0.001). Between 6 and 12 hours, DEOx1 was 0.51 (SD: 11.49) vs.-2.27 (SD: 12.32) (p=0.016). At more than 24 hours, it was 3.21 (SD: 9.22) vs. -3.8 (SD: 20.91) (p<0.001). Similar trends were observed on days 14 and 28. DEOx2 within 6 hours on day 7 was -19.02 (SD: 35.3) vs. -1.36 (SD: 14.31) (p<0.001), and between 6 and 12 hours, it was 7.57 (SD: 18.78) vs. -1.94 (SD: 11.73) (p<0.001). At more than 24 hours, it was 2.6 (SD: 10.75) vs. -4.54 (SD: 17.26) (p<0.001). This pattern persisted on days 14 and 28. Conclusion DEOx variability in critically ill COVID-19 patients was significantly associated with IMV need and mortality. Higher DEOx values at ≤6h and persistent metabolic derangement beyond 24h correlated with worse outcomes. |
| format | Article |
| id | doaj-art-559fdda548ee42a9b95937a0f11fe64b |
| institution | Kabale University |
| issn | 1471-2466 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj-art-559fdda548ee42a9b95937a0f11fe64b2025-08-20T03:45:44ZengBMCBMC Pulmonary Medicine1471-24662025-08-012511910.1186/s12890-025-03858-9Association between oxygen debt (DEOx) variability over time and clinical outcomes in critically ill COVID-19 patients: an observational studyEduardo Tuta-Quintero0Alirio Bastidas-Goyes1Henry Robayo-Amortegui2Michel Pérez-Garzón3Isacio Serna-Palacios4Cristian Peña-Quimbayo5Julian Espitia6Daniel Pinto7Johan Rincón8Juan Sánchez9Jesus Pérez10School of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaSchool of Medicina, Universidad de La SabanaAbstract Background Oxygen debt (DEOx) quantifies oxygen deficit during shock, reflecting the transition to anaerobic metabolism due to decreased oxygen delivery (DO₂). This study aimed to analyze the temporal variation of DEOx values and their association with invasive mechanical ventilation (IMV) requirement and survival in patients with severe COVID-19. Methods We conducted a retrospective cohort study including adult patients admitted to the ICU with confirmed SARS-CoV-2 infection at Clínica Universidad de La Sabana (Colombia) between July 2020 and December 2021. DEOx was calculated using two validated formulas: one based on lactate (DEOx1) and another incorporating lactate and base excess (DEOx2). Variability in DEOx was assessed at different time points (≤6h, 6-12h, 12-24h, >24h) and its association with IMV and survival outcomes was analyzed. Results A total of 597 patients were included, of whom 150 (25.1%) died. DEOx1 within 6 hours was -6.87 (SD: 23.72) in patients requiring IMV by day 7, compared to -1.2 (SD: 7.83) in patients without IMV (p=0.004). DEOx2 within 6 hours on day 7 was -7.92 (SD: 30.7) vs. -1.57 (SD: 14.65) (p=0.027), and between 6 and 12 hours, it was 1.24 (SD: 14.92) vs. -3.54 (SD: 9.34) (p<0.001). 24 hours (SD: 36.09) in deceased patients on day 7, compared to -2.09 (SD: 14.26) in survivors (p<0.001). Between 6 and 12 hours, DEOx1 was 0.51 (SD: 11.49) vs.-2.27 (SD: 12.32) (p=0.016). At more than 24 hours, it was 3.21 (SD: 9.22) vs. -3.8 (SD: 20.91) (p<0.001). Similar trends were observed on days 14 and 28. DEOx2 within 6 hours on day 7 was -19.02 (SD: 35.3) vs. -1.36 (SD: 14.31) (p<0.001), and between 6 and 12 hours, it was 7.57 (SD: 18.78) vs. -1.94 (SD: 11.73) (p<0.001). At more than 24 hours, it was 2.6 (SD: 10.75) vs. -4.54 (SD: 17.26) (p<0.001). This pattern persisted on days 14 and 28. Conclusion DEOx variability in critically ill COVID-19 patients was significantly associated with IMV need and mortality. Higher DEOx values at ≤6h and persistent metabolic derangement beyond 24h correlated with worse outcomes.https://doi.org/10.1186/s12890-025-03858-9Critical careMultiple organ dysfunction syndromeOrgan dysfunction scoresOxygen debt |
| spellingShingle | Eduardo Tuta-Quintero Alirio Bastidas-Goyes Henry Robayo-Amortegui Michel Pérez-Garzón Isacio Serna-Palacios Cristian Peña-Quimbayo Julian Espitia Daniel Pinto Johan Rincón Juan Sánchez Jesus Pérez Association between oxygen debt (DEOx) variability over time and clinical outcomes in critically ill COVID-19 patients: an observational study BMC Pulmonary Medicine Critical care Multiple organ dysfunction syndrome Organ dysfunction scores Oxygen debt |
| title | Association between oxygen debt (DEOx) variability over time and clinical outcomes in critically ill COVID-19 patients: an observational study |
| title_full | Association between oxygen debt (DEOx) variability over time and clinical outcomes in critically ill COVID-19 patients: an observational study |
| title_fullStr | Association between oxygen debt (DEOx) variability over time and clinical outcomes in critically ill COVID-19 patients: an observational study |
| title_full_unstemmed | Association between oxygen debt (DEOx) variability over time and clinical outcomes in critically ill COVID-19 patients: an observational study |
| title_short | Association between oxygen debt (DEOx) variability over time and clinical outcomes in critically ill COVID-19 patients: an observational study |
| title_sort | association between oxygen debt deox variability over time and clinical outcomes in critically ill covid 19 patients an observational study |
| topic | Critical care Multiple organ dysfunction syndrome Organ dysfunction scores Oxygen debt |
| url | https://doi.org/10.1186/s12890-025-03858-9 |
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