Physiologic responses to a staircase lung volume optimization maneuver in pediatric high-frequency oscillatory ventilation

Annals of Intensive Care

Table 2 Classification results from plots of metrics for oxygenation, proximal pressure amplitude (ΔP_proximal) and tidal volume (V_t) plotted against the continuous distending pressure (CDP) with corresponding sensitivity, specificity, positive and negative predictive value calculated using the respiratory inductance plethysmography–CDP plots as reference, and Fleiss’ Kappa

Variable	Changes observed	LVOM outcome		Sensitivity	Specificity	Positive predictive value	Negative predictive value	ROC AUC (95% CI)	Fleiss kappa
Variable	Changes observed	Responsive	Unresponsive	Sensitivity	Specificity	Positive predictive value	Negative predictive value	ROC AUC (95% CI)	Fleiss kappa
During lung volume optimization maneuvre
Oxygenation–CDP	Increase, suggestive for lung volume recruitment	36/41	6/13	87.8	53.8	85.7%	58.3%	0.71 (0.53–0.89)	0.431
Oxygenation–CDP	No change or decrease	5/41	7/13	87.8	53.8	85.7%	58.3%	0.71 (0.53–0.89)	0.431
ΔP_proximal–CDP	Decrease, suggestive for increased compliance	12/41	3/13	29.3	76.9	80.0%	25.6%	0.53 (0.35–0.71)	0.782
ΔP_proximal–CDP	No change or increase	29/41	10/13	29.3	76.9	80.0%	25.6%	0.53 (0.35–0.71)	0.782
V_t–CDP curve	Increase, suggestive for lung volume recruitment	31/35	10/11	88.6	9.1	75.6%	20.0%	0.49 (0.29–0.68)	0.866
	No change or decrease	4/35	1/11	88.6	9.1	75.6%	20.0%	0.49 (0.29–0.68)	0.866
After lung volume optimization maneuvre
SpO₂/FiO₂ ratio at the end of the maneuvre	Increase ≥ 20%	22/41	5/13	53.7	61.5	81.4%	29.6%	0.58 (0.40–0.75)	N/A
SpO₂/FiO₂ ratio at the end of the maneuvre	Decrease or increase < 20%	19/41	8/13	53.7	61.5	81.4%	29.6%	0.58 (0.40–0.75)	N/A
SpO₂/FiO₂ ratio 1 h after the maneuvre	Increase ≥ 20%	38/41	3/13	92.7	76.9	92.6%	76.9%	0.85 (0.70–0.99)	N/A
SpO₂/FiO₂ ratio 1 h after the maneuvre	Decrease or increase < 20%	3/41	10/13	92.7	76.9	92.6%	76.9%	0.85 (0.70–0.99)	N/A

The lower panel summarizes changes in SpO₂/FiO₂ ratio at the last applied CDP during the decremental phase (T2) and one hour after (T3) after the lung volume optimization maneuver (LVOM). Data are depicted as median (25–75 interquartile range) or absolute number. ROC AUC receiver operating characteristic area under the curve; 95% confidence interval