Department of Anesthesiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan Er Road, Yu Zhong District, Chongqing, 400014, People's Republic of China.
Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, People's Republic of China.
J Anesth. 2024 Aug;38(4):508-515. doi: 10.1007/s00540-024-03348-y. Epub 2024 May 28.
The objective of this study was to evaluate whether adjusting the oxygen concentration guided by the Oxygen Reserve Index (ORI) during pediatric laryngeal surgery with High Flow Nasal Cannula Oxygen (HFNO) could achieve postoperative PaO close to physiological levels while ensuring adequate oxygenation in surgery.
Sixty pediatric patients undergoing laryngeal surgery or examination were randomly assigned to two groups. The ORI group received oxygen concentration adjustments every 5 min to maintain a target ORI value of 0.21, whereas the control group did not undergo any adjustments. Postoperative PaO, time weighted average fraction of inspired oxygen (FiO), and mean Peripheral Oxygen Saturation (SpO) were compared between groups. Finally, some analyses were conducted to examine the relationship of ORI with PaO.
In general, the postoperative PaO was 164.9 ± 48.8 mmHg in ORI group and 323.0 ± 87.7 mmHg in control group (P < 0.01). The time weighted average FiO in the ORI group was 85.9 [81.8-92.7] %. There was no significant difference in mean SpO between the two groups (ORI vs. control: 98.4 [97.7-99.2] vs. 98.8 [97.7-99.5]; P = 0.36). According to the analyses, the optimal cut value for ORI was determined to be 0.195 when PaO was 150 mmHg.
In pediatric laryngeal surgery with HFNO, reducing oxygen concentration guided by ORI helped achieve postoperative PaO levels closer to physiological norms without compromising intra-operative oxygenation.
本研究旨在评估在使用高流量鼻导管给氧（HFNO）进行小儿喉部手术时，通过调整氧储备指数（ORI）指导下的氧浓度，是否可以在确保术中充分氧合的同时，使术后 PaO 接近生理水平。
将 60 例行喉部手术或检查的小儿患者随机分为两组。ORI 组每 5 分钟调整一次氧浓度，以维持目标 ORI 值为 0.21，而对照组则不进行任何调整。比较两组患者术后 PaO、时间加权平均吸入氧分数（FiO）和平均外周血氧饱和度（SpO）。最后，进行了一些分析以研究 ORI 与 PaO 的关系。
一般来说，ORI 组术后 PaO 为 164.9±48.8mmHg，对照组为 323.0±87.7mmHg（P<0.01）。ORI 组时间加权平均 FiO 为 85.9[81.8-92.7]%。两组间平均 SpO 无显著差异（ORI 组与对照组：98.4[97.7-99.2]%与 98.8[97.7-99.5]%；P=0.36）。根据分析，当 PaO 为 150mmHg 时，ORI 的最佳截断值为 0.195。
在 HFNO 辅助下进行小儿喉部手术时，通过 ORI 指导降低氧浓度有助于使术后 PaO 水平更接近生理标准，而不会影响术中氧合。
