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.
METHODS: Randomised controlled trial.
METHODS: A tertiary care paediatric hospital.
METHODS: Paediatric patients aged 18 years or less scheduled to undergo laryngeal microsurgery.
METHODS: 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.
METHODS: 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).
CONCLUSIONS: 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%.
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.
METHODS: Randomised controlled trial.
METHODS: A tertiary care paediatric hospital.
METHODS: Paediatric patients aged 18 years or less scheduled to undergo laryngeal microsurgery.
METHODS: 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.
METHODS: 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).
CONCLUSIONS: 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%.
摘要：
背景：小儿喉部显微手术期间经常发生低氧血症。
目的：氧储备指数是评估100至200mmHg范围内的PaO2水平的无创连续参数。范围从0到1.0。我们调查了监测氧储备指数是否可以将SpO2的发生率降低90％或更低。
方法：随机对照试验。
方法：一家三级儿科医院。
方法：年龄在18岁或以下的儿科患者计划接受喉部显微手术。
方法：将患者随机分为氧储备指数组或对照组，并根据气管造口管的存在进行分层。在氧储备指数和对照组中，当氧储备指数为0.2或更低时，SpO2为94％或更低时进行抢救干预。分别。
方法：主要结果是手术期间SpO2的发生率为90%或更低。
结果：分析了88例患者的数据。氧储备指数和对照组之间SpO2≤90％的发生率没有差异[P=0.114；11/44，25％vs.18/44，40.9%；相对风险：1.27；95%置信区间（CI）：0.94至1.72]。在128个救援干预措施中，在氧储备指数和对照组中，75例事件中的18例（24％）和53例事件中的42例（79.2％）发生SpO2≤90％事件，分别（P<0.001；差异：55.2%；95%CI38.5至67.2%）。氧储备指数组患者的SpO2≤90%事件数（中位数0，最大值3）少于对照组（中位数0，最大值8，P=0.031）。
结论：氧储备指数的额外监测，在儿科气道手术期间，目标值大于0.2，除了外周血氧饱和度,未降低SpO2≤90%的发生率。
目的：氧储备指数是评估100至200mmHg范围内的PaO2水平的无创连续参数。范围从0到1.0。我们调查了监测氧储备指数是否可以将SpO2的发生率降低90％或更低。
方法：随机对照试验。
方法：一家三级儿科医院。
方法：年龄在18岁或以下的儿科患者计划接受喉部显微手术。
方法：将患者随机分为氧储备指数组或对照组，并根据气管造口管的存在进行分层。在氧储备指数和对照组中，当氧储备指数为0.2或更低时，SpO2为94％或更低时进行抢救干预。分别。
方法：主要结果是手术期间SpO2的发生率为90%或更低。
结果：分析了88例患者的数据。氧储备指数和对照组之间SpO2≤90％的发生率没有差异[P=0.114；11/44，25％vs.18/44，40.9%；相对风险：1.27；95%置信区间（CI）：0.94至1.72]。在128个救援干预措施中，在氧储备指数和对照组中，75例事件中的18例（24％）和53例事件中的42例（79.2％）发生SpO2≤90％事件，分别（P<0.001；差异：55.2%；95%CI38.5至67.2%）。氧储备指数组患者的SpO2≤90%事件数（中位数0，最大值3）少于对照组（中位数0，最大值8，P=0.031）。
结论：氧储备指数的额外监测，在儿科气道手术期间，目标值大于0.2，除了外周血氧饱和度,未降低SpO2≤90%的发生率。
