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Dynamics of Oxygen Reserve Index and Arterial Oxygen Partial Pressure in Children: A Prospective Observational Study

Jin-Tae Kim1, Jung-Bin Park1, Sang-Hwan Ji1

  • 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Paediatric Anaesthesia
|July 21, 2025
PubMed

Insights

The Oxygen Reserve Index (ORI) correlates with PaO2 in pediatric cardiac surgery patients. This noninvasive tool may help monitor oxygenation trends, unaffected by hemoglobin or ejection fraction.

Area of Science:

  • Anesthesiology
  • Pediatric Cardiology
  • Critical Care Medicine

Background:

  • The Oxygen Reserve Index (ORI) is a novel noninvasive parameter reflecting hyperoxic states.
  • Its relationship with arterial oxygen tension (PaO2) in pediatric patients is not well understood.
  • Monitoring oxygenation is crucial during pediatric cardiac surgery.

Purpose of the Study:

  • To investigate the relationship between ORI and PaO2 in pediatric patients undergoing cardiac surgery.
  • To identify factors influencing the ORI-PaO2 relationship.
  • To assess the utility of ORI as a monitoring tool in this population.

Main Methods:

  • Prospective observational study of 98 pediatric patients (<7 years) undergoing cardiac surgery.
  • ORI and PaO2 measurements at varying FiO2 levels (0.21, 0.5, 0.8) pre- and post-cardiopulmonary bypass (CPB).
  • Statistical analyses included linear mixed models, regression, and locally weighted regression, considering Hb, EF, and PI.

Main Results:

  • A nonlinear ORI-PaO2 relationship was observed, with a threshold at 245 mmHg.
  • Significant correlations between ORI and PaO2 were found in both ranges (r=0.516 and r=0.151).
  • Hemoglobin and ejection fraction did not impact the relationship; perfusion index showed a mild negative correlation pre-CPB.

Conclusions:

  • ORI consistently correlates with PaO2 in pediatric cardiac surgery patients.
  • The relationship is independent of hemoglobin and ejection fraction.
  • ORI shows potential as a valuable, noninvasive tool for monitoring oxygenation trends.
Abstract

Keywords:
arterial oxygen partial pressurecardiac surgerychildrenhyperoxiaoxygen reserve index

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