Early warning for SpO2 decrease by the oxygen reserve index in neonates and small infants

Publikationstyp:
Zeitschriftenaufsatz
Metadaten:
Abstract
<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Continuously assessing the oxygenation levels of patients to detect and prevent hypoxemia can be advantageous for safe anesthesia, especially in neonates and small infants. The oxygen reserve index (ORI) is a new parameter that can assess oxygenation through a relationship with arterial oxygen partial pressure (PaO<jats:sub>2</jats:sub>). The aim of this study was to examine whether the ORI provides a clinically relevant warning time for an impending SpO<jats:sub>2</jats:sub> (pulse oximetry hemoglobin saturation) reduction in neonates and small infants.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>ORI and SpO<jats:sub>2</jats:sub> were measured continuously in infants aged &lt;2 years during general anesthesia. The warning time and sensitivity of different ORI alarms for detecting impending SpO<jats:sub>2</jats:sub> decrease were calculated. Subsequently, the agreement of the ORI and PaO<jats:sub>2</jats:sub> with blood gas analyses was assessed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The ORI of 100 small infants and neonates with a median age of 9 months (min–max, 0–21 months) and weight of 8.35 kg (min–max, 2–13 kg) were measured. For the ORI/PaO<jats:sub>2</jats:sub> correlation, 54 blood gas analyses were performed. The warning time and sensitivity of the preset ORI alarm during the entire duration of anesthesia were 84 s (25th–75th percentile, 56–102 s) and 55% (95% CI 52%–58%), and those during anesthesia induction were 63 s (40–82 s) and 56% (44%–68%), respectively. The positive predictive value of the preset ORI alarm were 18% (95% CI 17%–20%; entire duration of anesthesia) and 27% (95% CI 21%–35%; during anesthesia induction). The agreement of PaO<jats:sub>2</jats:sub> intervals with the ORI intervals was poor, with a kappa of 0.00 (95% CI = [−0.18; 0.18]). The weight (<jats:italic>p</jats:italic> = .0129) and height (<jats:italic>p</jats:italic> = .0376) of the infants and neonates were correlated to the correct classification of the PaO<jats:sub>2</jats:sub> interval with the ORI interval.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The ORI provided an early warning time for detecting an impending SpO<jats:sub>2</jats:sub> decrease in small infants and neonates in the defined interval in this study. However, the sensitivity of ORI to forewarn a SpO<jats:sub>2</jats:sub> decrease and the agreement of the ORI with PaO<jats:sub>2</jats:sub> intervals in this real‐life scenario were too poor to recommend the ORI as a useful early warning indicator for this age group.</jats:p></jats:sec>
Autoren
  • Eva Wittenmeier
  • Irene Schmidtmann
  • Pascal Heese
  • Pascal Müller
  • Nicole Didion
  • Marc Kriege
  • Yannick Komorek
  • Nina Pirlich
DOI
10.1111/pan.14743
eISSN
1460-9592
ISSN
1155-5645
Ausgabe der Veröffentlichung
11
Zeitschrift
Pediatric Anesthesia
Sprache
en
Online publication date
2023
Paginierung
923 - 929
Datum der Veröffentlichung
2023
Status
Published
Herausgeber
Wiley
Herausgeber URL
http://dx.doi.org/10.1111/pan.14743
Datum der Datenerfassung
2023
Titel
Early warning for SpO<sub>2</sub> decrease by the oxygen reserve index in neonates and small infants
Ausgabe der Zeitschrift
33

Datenquelle: Crossref

Andere Metadatenquellen:
Author's licence
CC-BY
Autoren
  • Eva Wittenmeier
  • Irene Schmidtmann
  • Pascal Heese
  • Pascal Müller
  • Nicole Didion
  • Marc Kriege
  • Yannick Komorek
  • Nina Pirlich
Hosting institution
Universitätsbibliothek Mainz
Sammlungen
  • DFG-491381577-H
Resource version
Published version
DOI
10.1111/pan.14743
Funding acknowledgements
  • Deutsche Forschungsgemeinschaft (DFG)|491381577|Open-Access-Publikationskosten 2022–2024 Universität Mainz - Universitätsmedizin
File(s) embargoed
false
Open access
true
ISSN
1460-9592
Zeitschrift
Pediatric anesthesia
Schlüsselwörter
  • 610 Medizin
  • 610 Medical sciences
Sprache
eng
Open access status
Open Access
Datum der Veröffentlichung
2023
Public URL
https://openscience.ub.uni-mainz.de/handle/20.500.12030/9522
Herausgeber
Wiley-Blackwell
Datum der Datenerfassung
2023
Datum, an dem der Datensatz öffentlich gemacht wurde
2023
Zugang
Public
Titel
Early warning for SpO2 decrease by the oxygen reserve index in neonates and small infants
Ausgabe der Zeitschrift
Version of Record (VoR)

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early_warning_for_spo2_decrea-20230901105114311.pdf

Datenquelle: OPENSCIENCE.UB

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