Original scientific paper
https://doi.org/10.3325/cmj.2025.66.47
Evaluating oxygen reserve index-guided oxygenation for the prevention of postoperative delirium in elderly patients: a randomized controlled trial
Pelin Uzun Sarıtaş
; Department of Anesthesiology and Reanimation, İzmir City Hospital, İzmir, Turkey
*
Aykut Sarıtaş
; Department of Anesthesiology and Reanimation, Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey
Merve Çetin Poyraz
; Department of Anesthesiology and Reanimation, Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey
Uğur Uzun
; Department of Anesthesiology and Reanimation, Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey
* Corresponding author.
Abstract
Aim To assess the effect of oxygen reserve index (ORi)
guided titration of fraction of inspired oxygen (FiO2
) on
the incidence of postoperative delirium (POD) and the
frequency of hyperoxemia episodes, assuming a potential
link between hyperoxemia and POD.
Methods This randomized controlled trial included 114
patients aged 65 years and older, scheduled for elective
surgeries lasting over two hours at Health Sciences Univer
sity Tepecik Training and Research Hospital between Oc
tober 1, 2023, and July 7, 2024. Patients were randomized
into the control group (n = 57) or the ORi + pulse oximetry
(SpO2
) group (n = 57). In the ORi+SpO2
group, we dynami
cally adjusted FiO2
based on the real-time ORi and SpO2
values, targeting 95%
≤98% and ORi 0.00. In the con
trol group, FiO2
adjustments were guided solely by SpO2
readings, with ORi values recorded but not used for de
cision-making. POD was assessed with the Confusion As
sessment Method (CAM) and CAM-ICU at multiple time
points over 48 hours.
Results The incidence of POD was significantly higher in
the control group than in the ORi+SpO2
group (42.1% vs
12.3%, P < 0.001). The average FiO2
levels in the ORi+SpO2
group were significantly lower throughout surgery
(P < 0.001). The ORi+SpO2
group also exhibited a lower fre
quency of hyperoxemia episodes.
Conclusion The ORi-guided oxygenation strategy signif
icantly reduced the incidence of POD in elderly patients
by effectively minimizing intraoperative hyperoxemia. Op
timizing intraoperative oxygenation through non-invasive
monitoring may enhance perioperative outcomes.
Keywords
Hrčak ID:
352470
URI
Publication date:
20.2.2025.
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