Effectiveness of the oxygen reserve index in detecting and preventing hyperoxia in critically ill patients on
Aykut Sarıtaş1, Pelin Uzun Sarıtaş, Uğur Uzun
1Aykut Sarıtaş, Department of Anesthesiology and Reanimation, Health Sciences University, İzmir Faculty of Medicine, Tepecik Training and Research Hospital, Güney Mahallesi 1140/1 sokak no: 1 Yenişehir, 35000 Izmir, Turkey, aykut26tr@hotmail.com.
Aim:
To assess the effectiveness of fraction of inspired oxygen (FiO2) titration guided by oxygen reserve index (ORi) in preventing hyperoxia in intensive care unit (ICU) patients receiving mechanical ventilator support.
Methods:
Patients aged 18 years and older who were admitted to a tertiary ICU and required mechanical ventilator support were randomly divided into two groups: the control group (n=30) and the oxygen saturation (SpO2) +ORi group (n=30). In the SpO2+ORi group, the goal was to maintain SpO2 between 95% and 98% and ORi at 0.00. In both groups, SpO2, ORi, partial pressure of oxygen (PaO2), partial pressure of carbon dioxide, positive end-expiratory pressure, FiO2, and hemodynamic parameters were recorded every six hours for two consecutive days.
Results:
A very strong positive linear correlation was found between PaO2 and ORi (r=0.937; P<0.001). In the ORi+SpO2 group, PaO2 values were significantly lower and decreased with FiO2 titration over time. Severe hyperoxia was observed in 24.8% of the control group and in only 3.3% of the ORi+SpO2 group. When PaO2>120 mm Hg, FiO2>0.40 was found in 83.5% of the control group, and in 40% of the ORi+SpO2 group.
Conclusion:
FiO2 titration guided by ORi+SpO2 effectively prevents hyperoxia and reduces the exposure time to hyperoxia in critically ill patients.
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