Oxygen reserve index versus conventional peripheral oxygen saturation for prevention of hypoxaemia: A randomised controlled trial.

IF 4.2 2区 医学 Q1 ANESTHESIOLOGY European Journal of Anaesthesiology Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI:10.1097/EJA.0000000000002018
Eun-Hee Kim, Jung-Bin Park, Pyoyoon Kang, Sang-Hwan Ji, Young-Eun Jang, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim
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Abstract

Background: Hypoxaemia occurs frequently during paediatric laryngeal microsurgery.

Objective: The oxygen reserve index is a noninvasive and continuous parameter to assess PaO2 levels in the range of 100 to 200 mmHg. It ranges from 0 to 1.0. We investigated whether monitoring the oxygen reserve index can reduce the incidence of SpO2 90% or less.

Design: Randomised controlled trial.

Setting: A tertiary care paediatric hospital.

Participants: Paediatric patients aged 18 years or less scheduled to undergo laryngeal microsurgery.

Intervention: The patients were randomly allocated to the oxygen reserve index or control groups, and stratified based on the presence of a tracheostomy tube. Rescue intervention was performed when the oxygen reserve index was 0.2 or less and the SpO2 was 94% or less in the oxygen reserve index and control groups, respectively.

Main outcome measure: The primary outcome was the incidence of SpO2 90% or less during the surgery.

Results: Data from 88 patients were analysed. The incidence of SpO2 ≤ 90% did not differ between the oxygen reserve index and control groups [P = 0.114; 11/44, 25% vs. 18/44, 40.9%; relative risk: 1.27; and 95% confidence interval (CI): 0.94 to 1.72]. Among the 128 rescue interventions, SpO2 ≤ 90% event developed in 18 out of 75 events (24%) and 42 out of 53 events (79.2%) in the oxygen reserve index and control groups, respectively (P < 0.001; difference: 55.2%; and 95% CI 38.5 to 67.2%). The number of SpO2 ≤ 90% events per patient in the oxygen reserve index group (median 0, maximum 3) was less than that in the control group (median 0, maximum 8, P = 0.031).

Conclusion: Additional monitoring of the oxygen reserve index, with a target value of greater than 0.2 during paediatric airway surgery, alongside peripheral oxygen saturation, did not reduce the incidence of SpO2 ≤ 90%.

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氧储备指数与传统外周血氧饱和度在预防低氧血症方面的比较:随机对照试验。
背景:小儿喉显微手术过程中经常出现低氧血症:小儿喉显微手术过程中经常出现低氧血症:氧储备指数是一个无创和连续的参数,用于评估 100 至 200 mmHg 范围内的 PaO2 水平。其范围为 0 至 1.0。我们研究了监测氧储备指数是否能降低 SpO2 90% 或更低的发生率:随机对照试验:参与者:18 岁或以下的儿科患者:干预措施:将患者随机分配到氧储备指数组或对照组,并根据是否存在气管造口管进行分层。氧储备指数组和对照组分别在氧储备指数为 0.2 或更低和 SpO2 为 94% 或更低时进行抢救干预:结果:分析了 88 名患者的数据。氧储备指数组和对照组之间 SpO2 ≤ 90% 的发生率没有差异 [P = 0.114;11/44,25% 对 18/44,40.9%;相对风险:1.27;95% 置信区间 (CI):0.94 至 1.72]。在 128 例抢救干预中,氧储备指数组和对照组的 75 例事件中分别有 18 例(24%)和 53 例事件中分别有 42 例(79.2%)发生 SpO2 ≤ 90% 的事件(P 结论:SpO2 ≤ 90% 的事件在抢救干预中的发生率较高:在儿科气道手术期间,在监测外周血氧饱和度的同时额外监测氧储备指数(目标值大于 0.2)并不能降低 SpO2 ≤ 90% 的发生率。
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来源期刊
CiteScore
6.90
自引率
11.10%
发文量
351
审稿时长
6-12 weeks
期刊介绍: The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).
期刊最新文献
A big little problem - postoperative nausea and vomiting incidences are too low! Is it time to add the letter E to the airway management guidelines? Is permissive hypercapnia really pneumoprotective? Reply to: importance of accounting for repeated measure designs when evaluating treatment effects at multiple postoperative days. Rethinking the utility of comparative studies between direct and video laryngoscopy in neonates and infants.
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