{Reference Type}: Journal Article
{Title}: Oxygen reserve index versus conventional peripheral oxygen saturation for prevention of hypoxaemia: A randomised controlled trial.
{Author}: Kim EH;Park JB;Kang P;Ji SH;Jang YE;Lee JH;Kim HS;Kim JT;
{Journal}: Eur J Anaesthesiol
{Volume}: 41
{Issue}: 9
{Year}: 2024 Sep 1
{Factor}: 4.183
{DOI}: 10.1097/EJA.0000000000002018
{Abstract}: <B>BACKGROUND: </B>Hypoxaemia occurs frequently during paediatric laryngeal microsurgery.<BR><B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>Randomised controlled trial.<BR><B>METHODS: </B>A tertiary care paediatric hospital.<BR><B>METHODS: </B>Paediatric patients aged 18 years or less scheduled to undergo laryngeal microsurgery.<BR><B>METHODS: </B>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.<BR><B>METHODS: </B>The primary outcome was the incidence of SpO2 90% or less during the surgery.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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%.