Original scientific paper
https://doi.org/10.3325/cmj.2023.64.404
Effectiveness of the oxygen reserve index in detecting and preventing hyperoxia in critically ill patients on mechanical ventilation: a randomized controlled trial
Aykut Sarıtaş
; Health Sciences University, Izmir Faculty of Medicine, Tepecik Training and Research Hospital, Izmir, Turkey
*
Pelin Uzun Sarıtaş
; Tepecik Training and Research Hospital, Izmir, Turkey
Uğur Uzun
; Tepecik Training and Research Hospital, Izmir, Turkey
* Corresponding author.
Abstract
Aim To assess the effectiveness of fraction of inspired oxygen (FiO2
) titration guided by oxygen reserve index (ORi) in
preventing hyperoxia in intensive care unit (ICU) patients
receiving mechanical ventilator support.
Methods Patients aged 18 years and older who were admitted to a tertiary ICU and required mechanical ventilator support were randomly divided into two groups: the
control group (n=30) and the oxygen saturation (SpO2
)
+ORi group (n=30). In the SpO2
+ORi group, the goal was
to maintain SpO2
between 95% and 98% and ORi at 0.00. In
both groups, SpO2
, ORi, partial pressure of oxygen (PaO2
),
partial pressure of carbon dioxide, positive end-expiratory
pressure, FiO2
, and hemodynamic parameters were recorded every six hours for two consecutive days.
Results A very strong positive linear correlation was
found between PaO2
and ORi (r=0.937; P<0.001). In the
ORi+SpO2
group,
PaO2
values were significantly lower and
decreased with FiO2
titration over time. Severe hyperoxia
was observed in 24.8% of the control group and in only
3.3% of the ORi+SpO2
group. When PaO2
>120 mm Hg,
FiO2
>0.40 was found in 83.5% of the control group, and in
40% of the ORi+SpO2
group.
Conclusion FiO2
titration guided by ORi+SpO2
effectively
prevents hyperoxia and reduces the exposure time to hyperoxia in critically ill patients
Keywords
Hrčak ID:
331885
URI
Publication date:
21.12.2023.
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