FiO2: Difference between revisions

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{{Data_element
{{Data element
| field_name = Ap_FIO2
|field_name=Ap_FIO2
| CCMDB_label = FIO2
|CCMDB_label=FIO2
| element_description = FIO2 is the '''fraction of inspired oxygen'''[http://en.wikipedia.org/wiki/FiO2] in the gas mixture breathed by the patient.
|Rank=Apache
| in_table = L_Log
|in_table=L Log table
| data_type = number
|data_type=number
| datafield_length = single
|datafield_length=single
| program_collecting = CC
|program_collecting=CC
| created_raw = Raw
|created_raw=Raw
| data_element_sort_index = 67
|data_element_sort_index=67
|CCMDB_tab=Apache
|element_description=FIO2 is the '''fraction of inspired oxygen'''[http://en.wikipedia.org/wiki/FiO2] in the gas mixture breathed by the patient.
}}
}}
It is an element of the [[Arterial blood gas (APACHE)]].
It is an element of the [[Arterial blood gas (APACHE)]].


Line 16: Line 17:


== Collection Instructions ==
== Collection Instructions ==
* Enter the FiO2 by referencing the type and LPM in the table on your laptop in [[CCMDB.mdb]], or at the bottom of this article.  
There are special collection instructions for [[Arterial blood gas (APACHE)]], refer there for further info. FIO2 collection is impacted by this.
** Once entered, your choice will translate into a number. If you go back to the dropdown later to check what you have entered, the choices may not be what you entered, but they will be something that corresponds to the same percentage FiO2. In other words, you can not go back to this field later to see the type or LPM you entered originally.  


'''Your FIO2 will influence how you collect [[Arterial blood gas (APACHE)]], check that article for details.
Enter the FiO2 by choosing the type and LPM in the drop-down in [[CCMDB.accdb]].  


== Why we collect FiO2 ==
Once entered, your choice will translate into a number. If you go back to the dropdown later to check what you have entered, ''the type/LPM may not be what you entered'', but they will be something that corresponds to the same percentage FiO2. In other words, you can not go back to this field later to see the type or LPM you entered originally.  
FIO2 is used in the calculation of the [[APACHE Scoring table|APACHE score]].


== "Flush" for non-BiPAPs ==
*At least at HSC, the term "flush" is also used for rebreath. In that case, it means the oxygen flow meter is set at its maximal flow. What FIO2 value should be used for this? {{discussion}} [[User:Ttenbergen|Ttenbergen]] 14:39, 9 April 2010 (CDT) as per Marie Laporte
**I spoke to some members of the Transport team (RRTs) who state that once the flow meter is set at a maximal flow above 15L/min (flush)  it becomes difficult to determine exactly what the approximate FiO2 is.  Marie
*** OK, but what is to be used for collection? [[User:Ttenbergen|Ttenbergen]] 17:24, 1 November 2010 (CDT)
**** Any confirmation? What do you use if records say flush? Ttenbergen 14:06, 2014 September 19 (CDT)
****If anyone knows the answer to what Fi02 flush is, can they post here or is this still unknown what to use? I see in our program on the apache Fi02 choices we have a 100LNRB which gives 80 percent. Is that what we should use?[[User:GHall|GHall]] 11:59, 2016 June 30 (CDT)


===OptiFlow===
{{APACHE physiological variable
{{discussion}}
|AP phys name= fraction of inspired oxygen
*We need to address what FiO2 to use for Opti flow which is a specialized system with varying Oxygen flows. Probably will need to enlist respiratory to set up a table for this.--[[User:LKolesar|LKolesar]] 13:18, 2015 February 19 (CST)
|AP phys unit= percentage
*need a volunteer.[[User:TOstryzniuk|Trish Ostryzniuk]] 17:37, 2015 February 19 (CST)
|AP phys absMax= 100
|AP phys warnMax= 100
|AP 0as per [[AaDO2]]
|AP phys warnMin= 20
|AP phys absMin= 20
}}


== FiO2 dropdown ==
See drop-down in [[CCMDB.accdb]].


== FiO2 Reference Table==
These FIO2's are '''estimates''' only that we use for the collection of arterial blood gas (ABG's) data for APACHE II scoring]] purposes. The actual FiO2 that a patient gets varies due to a number of factors that are not accounted for in these estimates. (breath rate and depth, distance of O2 diffuser from face, resistance to flow etc.)
*The FIO2's listed in the table below are '''ESTIMATES ONLY''' that we use for the collection of arterial blood gas (ABG's) data for APACHE II scoring]] purposes.


*The actual FiO2 that a patient gets varies due to a number of factors that are not accounted for in these estimates. (breath rate and depth, distance of O2 diffuser from face, resistance to flow etc.)
[https://bloggingforyournoggin.wordpress.com/2016/03/29/oxygen-flow-rate-and-fio2-understand-the-relationship/ Here is a link] for an article that deals with the relationship between FiO2 and flow rate.  


{| class="wikitable" border=1 <hiddentext> set to 0 for no borders</hiddentext>
===OptiFlow===
|- style="background-color:#FFFF99" align="center" valign="bottom"
To get the FiO2 for optiflow
| width="67" height="15" | Type
* if available, use the optiflow or "high flow" when initiated by respiratory.
| width="48" | Code
* if that is not available, then as a default use the FIO2 you'd get with that oxygen flow with a regular nasal cannula
| width="41" | % of O2
| width="79" | Type
| width="75" | Code
| width="41" | % of O2
| width="78" | Type
| width="79" | Code
| width="41" | % of O2


|-
== Implementation ==
| height="16"  valign="bottom" |  No Value
The field draws its values from the [[S_FIO2 table]].
|  valign="bottom" | No Value
| align="center" valign="bottom" | 0
|style="background-color:#CCFFFF"  valign="bottom" | Cold Pot
|  valign="bottom" | 35 ColdPot
| align="center" valign="bottom" | 35
|style="background-color:#CCFFFF"  valign="bottom" | Partial Rebreath
|  valign="bottom" | 10 LRB
| align="center" valign="bottom" | 65
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | BIPAP
|  valign="bottom" | 5 L
| align="center" valign="bottom" | 40
|style="background-color:#CCFFFF"  valign="bottom" | Cold Pot
|  valign="bottom" | 40 ColdPot
| align="center" valign="bottom" | 40
|style="background-color:#CCFFFF"  valign="bottom" | Partial Rebreath
|  valign="bottom" | 12 LRB
| align="center" valign="bottom" | 65
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | BIPAP
|  valign="bottom" | 10 L
| align="center" valign="bottom" | 60
|style="background-color:#CCFFFF"  valign="bottom" | Cold Pot
|  valign="bottom" | 50 ColdPot
| align="center" valign="bottom" | 50
|style="background-color:#CCFFFF"  valign="bottom" | Partial Rebreath
|  valign="bottom" | 8 LRB
| align="center" valign="bottom" | 65
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | BIPAP
|  valign="bottom" | 15 L
| align="center" valign="bottom" | 70
|style="background-color:#CCFFFF"  valign="bottom" | Cold Pot
|  valign="bottom" | 70 ColdPot
| align="center" valign="bottom" | 70
|style="background-color:#CCFFFF"  valign="bottom" | Partial Rebreath
|  valign="bottom" | 10 LRB + 3 L NP
| align="center" valign="bottom" | 70
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | BIPAP
|  valign="bottom" | FLUSH
| align="center" valign="bottom" | 70
|style="background-color:#CCFFFF"  valign="bottom" | Cold Pot
|  valign="bottom" | 100 ColdPot
| align="center" valign="bottom" | 100
|style="background-color:#CCFFFF"  valign="bottom" | Partial Rebreath
|  valign="bottom" | 10 LRB + 5 L NP
| align="center" valign="bottom" | 70
 
|-
| height="16"  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
| align="center" valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
| align="center" valign="bottom" | &nbsp;
|style="background-color:#CCFFFF"  valign="bottom" | Partial Rebreath
|  valign="bottom" | 13 LRB
| align="center" valign="bottom" | 70
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | Nasal Prongs
|  valign="bottom" | Room Air
| align="center" valign="bottom" | 21
|style="background-color:#CCFFFF"  valign="bottom" | Non Rebreath
|  valign="bottom" | 10 LNRB
| align="center" valign="bottom" | 70
|style="background-color:#CCFFFF"  valign="bottom" | Partial Rebreath
|  valign="bottom" | 15 LRB
| align="center" valign="bottom" | 70
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | Nasal Prongs
|  valign="bottom" | 1 LNP
| align="center" valign="bottom" | 24
|style="background-color:#CCFFFF"  valign="bottom" | Non Rebreath
|  valign="bottom" | 15 LNRB
| align="center" valign="bottom" | 70
|style="background-color:#CCFFFF"  valign="bottom" | Partial Rebreath
|  valign="bottom" | 15 LRB + 5 L NP
| align="center" valign="bottom" | 70
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | Nasal Prongs
|  valign="bottom" | 2 LNP
| align="center" valign="bottom" | 28
|style="background-color:#CCFFFF"  valign="bottom" | Non Rebreath
|  valign="bottom" | 100 LNRB
| align="center" valign="bottom" | 80
|style="background-color:#CCFFFF"  valign="bottom" | Partial Rebreath
|  valign="bottom" | 15 LRB + 7 L NP
| align="center" valign="bottom" | 70
 
|-
|style="background-color:#CCFFFF" height="16"  valign="bottom" | Nasal Prongs
|  valign="bottom" | 3 LNP
| align="center" valign="bottom" | 32
|style="background-color:#CCFFFF"  valign="bottom" | Non Rebreath
|  valign="bottom" | 20 LNRB
| align="center" valign="bottom" | 80
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | Nasal Prongs
|  valign="bottom" | 4 LNP
| align="center" valign="bottom" | 36
|style="background-color:#CCFFFF"  valign="bottom" | Non Rebreath
|  valign="bottom" | 25 LNRB
| align="center" valign="bottom" | 80
|style="background-color:#CCFFFF"  valign="bottom" | Venturi Mask
|  valign="bottom" | 3 LPM
| align="center" valign="bottom" | 24
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | Nasal Prongs
|  valign="bottom" | 5 LNP
| align="center" valign="bottom" | 40
|style="background-color:#CCFFFF"  valign="bottom" | Non Rebreath
|  valign="bottom" | 30 LNRB
| align="center" valign="bottom" | 80
|style="background-color:#CCFFFF"  valign="bottom" | Venturi Mask
|  valign="bottom" | 4 LPM
| align="center" valign="bottom" | 26
 
|-
|style="background-color:#CCFFFF" height="16"  valign="bottom" | Nasal Prongs
|  valign="bottom" | 6 LNP
| align="center" valign="bottom" | 44
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
| align="center" valign="bottom" | &nbsp;
|style="background-color:#CCFFFF"  valign="bottom" | Venturi Mask
|  valign="bottom" | 5 LPM
| align="center" valign="bottom" | 28
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | Nasal Prongs
|  valign="bottom" | 7 LNP
| align="center" valign="bottom" | 48
|style="background-color:#CCFFFF"  valign="bottom" | Simple Flow
|  valign="bottom" | 6 Lpm
| align="center" valign="bottom" | 35
|style="background-color:#CCFFFF"  valign="bottom" | Venturi Mask
|  valign="bottom" | 6 LPM
| align="center" valign="bottom" | 30
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | Nasal Prongs
|  valign="bottom" | 8 LNP
| align="center" valign="bottom" | 50
|style="background-color:#CCFFFF"  valign="bottom" | Simple Flow
|  valign="bottom" | 7 Lpm
| align="center" valign="bottom" | 40
|style="background-color:#CCFFFF"  valign="bottom" | Venturi Mask
|  valign="bottom" | 9 LPM
| align="center" valign="bottom" | 35
 
|-
| height="16"  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
| align="center" valign="bottom" | &nbsp;
|style="background-color:#CCFFFF"  valign="bottom" | Simple Flow
|  valign="bottom" | 8 Lpm
| align="center" valign="bottom" | 45
|style="background-color:#CCFFFF"  valign="bottom" | Venturi Mask
|  valign="bottom" | 12 LPM
| align="center" valign="bottom" | 40
 
|-
|style="background-color:#CCFFFF" height="16"  valign="bottom" | OxyMask
|  valign="bottom" | 1 LPM
| align="center" valign="bottom" | 24
|style="background-color:#CCFFFF"  valign="bottom" | Simple Flow
|  valign="bottom" | 9 Lpm
| align="center" valign="bottom" | 50
|style="background-color:#CCFFFF"  valign="bottom" | Venturi Mask
|  valign="bottom" | 15 LPM
| align="center" valign="bottom" | 50
 
|-
|style="background-color:#CCFFFF" height="16"  valign="bottom" | OxyMask
|  valign="bottom" | 2 LPM
| align="center" valign="bottom" | 28
|style="background-color:#CCFFFF"  valign="bottom" | Simple Flow
|  valign="bottom" | 10 Lpm
| align="center" valign="bottom" | 55
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="16"  valign="bottom" | OxyMask
|  valign="bottom" | 3 LPM
| align="center" valign="bottom" | 32
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
| align="center" valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | OxyMask
|  valign="bottom" | 4 LPM
| align="center" valign="bottom" | 36
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 25 Vent
| align="center" valign="bottom" | 25
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 5 LPM
| align="center" valign="bottom" | 40
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 30 Vent
| align="center" valign="bottom" | 30
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 6 LPM
| align="center" valign="bottom" | 44
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 35 Vent
| align="center" valign="bottom" | 35
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 7 LPM
| align="center" valign="bottom" | 48
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 40 Vent
| align="center" valign="bottom" | 40
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 8 LPM
| align="center" valign="bottom" | 50
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 45 Vent
| align="center" valign="bottom" | 45
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 9 LPM
| align="center" valign="bottom" | 54
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 50 Vent
| align="center" valign="bottom" | 50
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 10 LPM
| align="center" valign="bottom" | 56
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 55 Vent
| align="center" valign="bottom" | 55
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 11 LPM
| align="center" valign="bottom" | 58
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 60 Vent
| align="center" valign="bottom" | 60
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 12 LPM
| align="center" valign="bottom" | 60
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 65 Vent
| align="center" valign="bottom" | 65
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 13 LPM
| align="center" valign="bottom" | 62
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 70 Vent
| align="center" valign="bottom" | 70
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="14"  valign="bottom" | OxyMask
|  valign="bottom" | 14 LPM
| align="center" valign="bottom" | 64
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 75 Vent
| align="center" valign="bottom" | 75
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
|style="background-color:#CCFFFF" height="15"  valign="bottom" | OxyMask
|  valign="bottom" | 15 LPM
| align="center" valign="bottom" | 65
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 85 Vent
| align="center" valign="bottom" | 80
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
| height="15"  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
| align="center" valign="bottom" | &nbsp;
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 85 Vent
| align="center" valign="bottom" | 85
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;


|-
== Data Integrity Checks ==
| height="14"  valign="bottom" | &nbsp;
{{Data Integrity Check List}}
|  valign="bottom" | &nbsp;
| align="center" valign="bottom" | &nbsp;
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 90 Vent
| align="center" valign="bottom" | 90
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;


|-
== Related articles ==
| height="14"  valign="bottom" | &nbsp;
{{Related Articles}}
|  valign="bottom" | &nbsp;
| align="center" valign="bottom" | &nbsp;
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 95 Vent
| align="center" valign="bottom" | 95
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|-
| height="15"  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
| align="center" valign="bottom" | &nbsp;
|style="background-color:#CCFFFF"  valign="bottom" | Ventilated
|  valign="bottom" | 100 Vent
| align="center" valign="bottom" | 100
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
|  valign="bottom" | &nbsp;
 
|}
 
== Implementation ==
The field draws its values from table [[S_FIO2]].


[[Category: ABG]]
[[Category: ABG]]
[[Category: Standards and Conventions]]

Latest revision as of 10:43, 2019 September 22

Data Element (edit)
Field Name: Ap_FIO2
CCMDB Label: FIO2
CCMDB tab: Apache
Table: L Log table
Data type: number
Length: single
Program: CC
Created/Raw: Raw
Start Date: 1988-07-11
End Date: 2300-01-01
Sort Index: 67

FIO2 is the fraction of inspired oxygen[1] in the gas mixture breathed by the patient.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


It is an element of the Arterial blood gas (APACHE).

See http://en.wikipedia.org/wiki/FiO2

Collection Instructions

There are special collection instructions for Arterial blood gas (APACHE), refer there for further info. FIO2 collection is impacted by this.

Enter the FiO2 by choosing the type and LPM in the drop-down in CCMDB.accdb.

Once entered, your choice will translate into a number. If you go back to the dropdown later to check what you have entered, the type/LPM may not be what you entered, but they will be something that corresponds to the same percentage FiO2. In other words, you can not go back to this field later to see the type or LPM you entered originally.


Apache Physiological Variable
variable name fraction of inspired oxygen
unit percentage
absolute max allowed 100
warning max 100
high score 4
high score 3
high score 2
high score 1
score 0 as per AaDO2
low score 1
low score 2
low score 3
low score 4
AP phys warnMin 20
AP phys absMin 20

APACHE Score

This value is used to generate the APACHE Score.

Collecting Apache physiological variables

There are some specific rules to follow in choosing which one of several lab results to collect.

See APACHE physiological variable collection for details.

Cross Chcks

Rules described in APACHE_physiological_variable_collection#Exceptionally_high_or_low_values are implemented by Check APACHE physiological variable high low.

FiO2 dropdown

See drop-down in CCMDB.accdb.

These FIO2's are estimates only that we use for the collection of arterial blood gas (ABG's) data for APACHE II scoring]] purposes. The actual FiO2 that a patient gets varies due to a number of factors that are not accounted for in these estimates. (breath rate and depth, distance of O2 diffuser from face, resistance to flow etc.)

Here is a link for an article that deals with the relationship between FiO2 and flow rate.

OptiFlow

To get the FiO2 for optiflow

  • if available, use the optiflow or "high flow" when initiated by respiratory.
  • if that is not available, then as a default use the FIO2 you'd get with that oxygen flow with a regular nasal cannula

Implementation

The field draws its values from the S_FIO2 table.

Data Integrity Checks

Data Integrity Checks (automatic list)

 AppStatus
Check APACHE physiological variable high lowCCMDB.accdbimplemented

Related articles

Related articles: