Alanazi Ibrahim, Algarni Saleh S, Alshreedah Saad, Alotaibi Naif, Sufyani Mohammed, Alanazi Sami S, Alharthi Abeer H, Ghazwani Abadi, Almutairi Omar M, Alkaabi Maryam, Homedi Abdulaziz, Ali Ibrahim, Khawaji Mohammed, Alsaif Saif, Ali Kamal
Neonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Front Pediatr. 2025 Feb 17;13:1476885. doi: 10.3389/fped.2025.1476885. eCollection 2025.
This study aims to evaluate the association between the Oxygenation Index (OI) and the Oxygen Saturation Index (OSI) in extremely preterm infants. In addition, the study seeks to determine the predictive value of these indices for mortality in the first 7 days and Bronchopulmonary Dysplasia (BPD) at 36 weeks postmenstrual age (PMA).
This is a prospective observational study conducted at King Abdulaziz Medical City, Riyadh between October 2023 and May 2024, involving extremely preterm infants with clinical and ventilator data collected during the first 7 days of life. The predictive capabilities of OI and OSI for mortality within the first 7 days and BPD at 36 wks. PMA were assessed using Area Under the Curve (AUC) analysis, while associations between indices were explored through Spearman's correlation coefficient.
The study included 85 infants with a mean birth weight of 856 grams (SD = 243) and a mean gestational age of 26 weeks (SD = 1.8). There was a strong positive correlation between OI and OSI overall ( = 0.848, < 0.001, = 85), with similar findings in both surviving ( = 0.831, < 0.001, = 71) and non-surviving groups ( = 0.896, < 0.001, = 14). Bland-Altman plots showed a mean difference of 3 between OI and OSI for all infants, with limits ranging from -4 to +8. Tighter agreement was observed in survivors with a mean difference of 2 and limit from -4 to +7, while non-survivors showed a larger mean difference of 4.5 and wider limits of agreement from -8 to +17. Receiver Operating Characteristic (ROC) analysis for survival prediction focused on indices measured within the first 24 h, demonstrating high predictive accuracy. Additionally, the mean daily values for OI and OSI between Day 4 and Day 7 were found to be predictive of BPD at 36 wk. PMA.
Measurements of OI and OSI within the first 24 h effectively predict mortality in extremely preterm infants. Additionally, daily mean values of OI and OSI from day 4 to day 7 were predictive of BPD at 36 weeks PMA. Further research is needed to refine these diagnostic thresholds to enhance neonatal care outcomes.
本研究旨在评估极早产儿的氧合指数（OI）与氧饱和度指数（OSI）之间的关联。此外，该研究还试图确定这些指数对出生后7天内死亡率以及孕龄36周时支气管肺发育不良（BPD）的预测价值。
这是一项前瞻性观察性研究，于2023年10月至2024年5月在利雅得的阿卜杜勒阿齐兹国王医疗城进行，研究对象为极早产儿，收集了其出生后7天内的临床和呼吸机数据。使用曲线下面积（AUC）分析评估OI和OSI对出生后7天内死亡率以及孕龄36周时BPD的预测能力，同时通过Spearman相关系数探索各指数之间的关联。
该研究纳入了85例婴儿，平均出生体重为856克（标准差=243），平均胎龄为26周（标准差=1.8）。总体而言，OI与OSI之间存在强正相关（r=0.848，p<0.001，n=85），存活组（r=0.831，p<0.001，n=71）和非存活组（r=0.896，p<0.001，n=14）也有类似结果。Bland-Altman图显示，所有婴儿的OI与OSI平均差异为3，范围在-4至+8之间。存活者的一致性更强，平均差异为2，范围在-4至+7之间，而非存活者的平均差异更大，为4.5，一致性范围更宽，在-8至+17之间。用于生存预测的受试者工作特征（ROC）分析聚焦于出生后24小时内测量的指数，显示出较高的预测准确性。此外，发现第4天至第7天的OI和OSI每日平均值可预测孕龄36周时的BPD。
出生后24小时内测量的OI和OSI能有效预测极早产儿的死亡率。此外，第4天至第7天的OI和OSI每日平均值可预测孕龄36周时的BPD。需要进一步研究以完善这些诊断阈值，改善新生儿护理结局。
