Aykut Sarıtaş, Department of Anesthesiology and Reanimation, Health Sciences University, İzmir Faculty of Medicine, Tepecik Training and Research Hospital, Güney Mahallesi 1140/1 sokak no: 1 Yenişehir, 35000 Izmir, Turkey,
Croat Med J. 2023 Dec 31;64(6):404-412. doi: 10.3325/cmj.2023.64.404.
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.
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.
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.
FiO2 titration guided by ORi+SpO2 effectively prevents hyperoxia and reduces the exposure time to hyperoxia in critically ill patients.
评估氧储备指数（ORi）指导下吸氧分数（FiO2）滴定预防接受机械通气支持的重症监护病房（ICU）患者发生高氧血症的效果。
选择年龄≥18 岁、入住三级 ICU 并需要机械通气支持的患者，随机分为两组：对照组（n=30）和氧饱和度（SpO2）+ORi 组（n=30）。在 SpO2+ORi 组中，目标是将 SpO2维持在 95%~98%，ORi 为 0.00。两组患者每 6 小时记录 SpO2、ORi、氧分压（PaO2）、二氧化碳分压、呼气末正压、FiO2 及血流动力学参数，连续记录 2 天。
PaO2 与 ORi 之间存在很强的正线性相关（r=0.937；P<0.001）。在 ORi+SpO2 组中，PaO2 值随着 FiO2 滴定逐渐降低，且呈时间依赖性。对照组中 24.8%的患者发生严重高氧血症，而 ORi+SpO2 组仅 3.3%的患者发生。当 PaO2>120 mm Hg 时，对照组中 83.5%的患者 FiO2>0.40，而 ORi+SpO2 组中 40%的患者 FiO2>0.40。
ORi+SpO2 指导的 FiO2 滴定可有效预防高氧血症，并降低危重症患者高氧血症暴露时间。
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