Integrated pulmonary index in pediatric sedation for endoscopy: a prospective cohort study

Integrated pulmonary index (IPI^™) is a device working with fuzzy logic principle that analyzes patient's end-tidal carbon dioxide (ETCO2), respiratory rate (RR), peripheral oxygen saturation (SpO2), and pulse rate and provides a number between 1 and 10. We aimed to investigate the usefulness of IPI monitor in pediatric patients.

After the Investigational Review Board approval pediatric patients undergoing gastrointestinal endoscopy under sedation were recruited. Propofol (Group P) and ketamine (Group K) were used for sedation. The primary outcome measure was average periprocedural IPI values. Secondary outcome measures were recovery time, endoscopist, and anesthetist satisfactions. Correlation of IPI values with physiological parameters was examined as well.

Periprocedural IPI scores were comparable between the groups (6.3 [4.9-7] vs. 6.8 [5.3-7.6] in Group P and Group K, respectively, p = 0.153). Recovery time was significantly longer in Group K (p < 0.001). Endoscopist and anesthetist satisfaction scores were comparable. Low IPI scores were significantly associated with low ETCO2, RR, and SpO2 values (p < 0.001).

IPI monitor is a valuable tool in the monitorization of the pediatric patients undergoing sedation with propofol and ketamine. Both drugs are associated with comparable IPI scores. ETCO2, RR, and SpO2 values are measured lower in patients with low IPI scores (1-3 points).