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氧储备指数与动脉血氧分压:体外循环心脏手术中的关系。

Oxygen Reserve Index and Arterial Partial Pressure of Oxygen: Relationship in Open Heart Surgery.

机构信息

Al-Babtain Cardiac Center, Dammam, Saudi Arabia.

Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.

出版信息

J Clin Monit Comput. 2023 Dec;37(6):1435-1440. doi: 10.1007/s10877-023-01001-9. Epub 2023 Apr 7.

Abstract

BACKGROUND

Mild to moderate hyperoxia is potentially beneficial to patients undergoing open heart surgery. Oxygen Reserve Index (ORI) is a novel parameter that correlates to arterial oxygen tension (PaO) in the hyperoxic range. This prospective study aimed to assess whether the relationship between ORI and PaO remains intact in the setting of open-heart surgery.

METHODS

This study included patients undergoing valve, aortic arch and coronary artery bypass grafting (CABG) surgeries, on and off pump, between September 1st 2019 and August 31st 2021. Enrolled patients had arterial blood gas samples collected and analyzed after induction of anesthesia and increases in FiO in steps of 0.08 with ORI being recorded at the time of sample collection for cross reference and analysis.

RESULTS

ORI values showed a statistically significant correlation with PaO values in the 100-200 mmHg range (r = 0.8193, p < 0.001). Additionally, there was a significant correlation between ORI and SpO values in the range of 95% and 100% (r = 0.529, p < 0.05).

CONCLUSIONS

The preserved relationship between ORI and PaO in the mild and moderate hyperoxic range can allow more precise titration of oxygen therapy to guide therapy targeting normoxia, mildly and moderately hyperoxia. Additionally, it could have a potential use as an early warning system for impeding hypoxia.

摘要

背景

轻度至中度高氧对接受心脏直视手术的患者可能有益。氧储备指数(ORI)是一种新的参数,与高氧范围内的动脉氧分压(PaO)相关。本前瞻性研究旨在评估在心脏直视手术中,ORI 与 PaO 之间的关系是否仍然存在。

方法

本研究纳入了 2019 年 9 月 1 日至 2021 年 8 月 31 日期间接受瓣膜、主动脉弓和冠状动脉旁路移植术(CABG)的患者,包括体外循环和非体外循环患者。患者在麻醉诱导后采集动脉血气样本并进行分析,然后以 0.08 的步长增加 FiO2,同时在样本采集时记录 ORI 值以进行交叉参考和分析。

结果

ORI 值在 100-200mmHg 范围内与 PaO 值呈统计学显著相关(r=0.8193,p<0.001)。此外,ORI 值与 SpO 95%-100%范围内的值呈显著相关(r=0.529,p<0.05)。

结论

在轻度至中度高氧范围内,ORI 与 PaO 之间的关系保持不变,可以更精确地滴定氧疗以指导针对正常氧合、轻度和中度高氧的治疗。此外,它可能作为一种早期预警系统,用于阻止缺氧的发生。

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