Related Experiment Video
Updated: Jun 10, 2025

Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
Oxygen titration with Oxygen Reserve Index in minimally invasive repair of pectus excavatum, a randomized controlled
Agshin Mirzayev1, Gul Cakmak1, Ruslan Abdullayev1
1Department of Anesthesiology and Intensive Care, Marmara University Faculty of Medicine, Istanbul, Turkiye.
Objective:
Perioperative hypoxemia is common during minimally invasive repair of pectus excavatum (MIRPE). Oxygen Reserve Index (ORI™) is a noninvasive method that shows blood oxygenation status. In addition, this method provides information about hypoxemia earlier than pulse oximetry. The primary aim of this study was to examine the value of ORI monitoring as an early predictor of hypoxemia during surgery. The secondary aim was to evaluate the value of ORI monitoring as a guide for oxygen titration to prevent hyperoxemia.
Methods:
This randomized controlled study enrolled 128 pediatric patients aged 8-18 years scheduled for elective MIRPE surgery. Patients were followed up with continuous peripheral oxygen saturation (SpO2) measurement in the control group (Group C) and continuous ORI monitoring in the study group (Group O). After pneumothorax, a decrease of 1% in basal SpO2 and 0.05 from basal ORI was considered clinically significant. Patient demographics, pre-induction, pre-first and second pneumothorax, and postoperative ORI, mean arterial pressure, temperature, perfusion index, end-tidal carbon dioxide values, length of hospital stay, anesthesia, and surgery durations were recorded.
Results:
Desaturation time was 59.46±15.57 seconds in Group O based on ORI, and 177.64±20.94 seconds in Group C according to SpO2, and the difference was significant (p<0.001). Use of FiO2>0.6 was lower in Group O, compared with Group C (p<0.05). Length of hospital stay was lower in Group O (p=0.002).
Conclusion:
ORI may detect hypoxemia earlier than SpO2 monitoring during MIRPE surgery. ORI monitorization decreases exposure time to high oxygen concentrations and may increase patient safety during MIRPE surgery in pediatric patients.
Related Concept Videos
Pneumothorax-II
Clinical Manifestations:
Pneumothorax-I
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
Cardiopulmonary Resuscitation II: ACLS Airway Management
Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...

