Association between oxygenation and ventilation indices with the time on invasive mechanical ventilation in infants

Area of Science:

• Pediatric Critical Care Medicine
• Respiratory Physiology
• Neonatology

Background:

• Invasive mechanical ventilation (IMV) is a cornerstone of pediatric intensive care unit (PICU) management for infants.
• The predictive value of oxygenation index (OI) and ventilation index (VI) for the duration of IMV in this population remains incompletely understood.

Purpose of the Study:

• To investigate the association between early ventilatory parameters, oxygenation (OI), and ventilation (VI) indices and the duration of IMV in infants.
• To determine if OI and VI can serve as predictors for prolonged IMV.

Main Methods:

• A prospective study involving infants up to 24 months old requiring IMV in a PICU over two years.
• Ventilatory parameters, blood gases, OI, and VI were collected within the first seven days of IMV.
• Infants were categorized into short-term (≤7 days) and long-term (>7 days) IMV groups for comparative analysis.

Main Results:

• Infants requiring long-term IMV showed significantly higher values for FiO2, inspiratory pressure (Pinsp), positive end-expiratory pressure (PEEP), respiratory rate, airway pressure (Paw), OI, and VI from the first to the seventh day compared to short-term IMV infants.
• Conversely, short-term IMV infants exhibited higher PaO2 and PaO2/FiO2 ratios on specific days.
• Differences in PaCO2 were noted on the second day.

Conclusions:

• The oxygenation index (OI) and ventilation index (VI) show potential as early predictors for identifying infants at risk of requiring prolonged invasive mechanical ventilation.
• These indices, alongside other monitored parameters, can aid clinicians in anticipating and managing extended ventilation needs in critically ill infants.