Zengin Hilal
Department of Anesthesiology and Reanimation, University of Health Sciences, Gulhane Training and Research Hospital, Etlik, Ankara, 06010, Turkey.
BMC Anesthesiol. 2025 Jan 27;25(1):42. doi: 10.1186/s12871-024-02877-z.
INTRODUCTION-OBJECTIVE: Hyperoxia is associated with acute lung injury and atelectasis. Arterial blood gas measurement is an invasive method. The Oxygen Reserve Index (ORI) was developed to monitor the oxygen values of patients. In this study, we aimed to find out whether safe monitoring against hyperoxia could be achieved in Robotic-Assisted Radical Prostatectomy (RARP) operations by using ORI, which is an easier measurement method compared to arterial blood gas measurements.
The study was carried out with adult male patients over the age of 18 who underwent RARP with the diagnosis of prostate cancer. An ORI pulse oximeter was additionally attached to their index fingers for ORI monitoring. The moment when ORI values were first read was considered the baseline, and arterial blood gas and ORI values were recorded simultaneously at the baseline (T1), 30 min later (T2), 1 h later (T3), 3 h later (T4), and 5 h later (T5). The correlations between the simultaneously recorded ORI and arterial blood gas values were analyzed.
The sample of the study included 24 male patients. The mean age of the patients was 63.30 ± 7.74, their mean BMI (kg/m) was 26.64 ± 2.84, and their mean duration of operation was 351.52 ± 48.72 min. The mean ORI value in all measurements was 0.36 (median: 0.28, SD: 0.3694). In the ROC curve analysis conducted to determine the optimal cut-off point for ORI to detect PaO ≥ 150 mmHg, the AUC was 0.901 (95% CI: 0.821-0.981), and the cut-off value obtained based on the ROC curve (cut point ORI) was 0.220 (sensitivity: 0.826, specificity: 0.771). The results of the linear regression analysis showed a strong relationship between ORI and PaO (PaO < 240 mmHg) [simple linear regression, n = 90; r = 0.505, p < 0.001].
The results of this study demonstrated a significant connection between ORI and PO values in their simultaneous interpretation at PO values lower than 240. Because the sensitivity of ORI to PO is low in cases of severe hyperoxia, blood gas analyses will be needed.
引言 - 目的：高氧血症与急性肺损伤和肺不张相关。动脉血气测量是一种侵入性方法。氧储备指数（ORI）被开发用于监测患者的氧值。在本研究中，我们旨在探究通过使用ORI（一种与动脉血气测量相比更简便的测量方法），在机器人辅助根治性前列腺切除术（RARP）手术中是否能够实现对高氧血症的安全监测。
本研究针对年龄在18岁以上、被诊断为前列腺癌并接受RARP手术的成年男性患者开展。另外在他们的食指上连接一台ORI脉搏血氧仪以进行ORI监测。首次读取ORI值的时刻被视为基线，在基线（T1）、30分钟后（T2）、1小时后（T3）、3小时后（T4）和5小时后（T5）同时记录动脉血气和ORI值。分析同时记录的ORI与动脉血气值之间的相关性。
本研究样本包括24名男性患者。患者的平均年龄为63.30 ± 7.74岁，平均体重指数（kg/m）为26.64 ± 2.84，平均手术时长为351.52 ± 48.72分钟。所有测量中的平均ORI值为0.36（中位数：0.28，标准差：0.3694）。在为确定ORI检测PaO≥150 mmHg的最佳截断点而进行的ROC曲线分析中，AUC为0.901（95%可信区间：0.821 - 0.981），基于ROC曲线获得的截断值（截断点ORI）为0.220（敏感性：0.826，特异性：0.771）。线性回归分析结果显示ORI与PaO（PaO < 240 mmHg）之间存在强相关性[简单线性回归，n = 90；r = 0.505，p < 0.001]。
本研究结果表明，在PO值低于240时同时解读ORI与PO值之间存在显著关联。由于在严重高氧血症情况下ORI对PO的敏感性较低，因此仍需要进行血气分析。
