Oxygen concentration titration guided by oxygen reserve index during pediatric laryngeal surgery with high-flow nasal cannula oxygen: a randomized controlled trial

作者全名："Li, Haisu; Liu, Jianxia; Xiong, Ling; Duan, Guangyou; Xu, Ying"

作者地址："[Li, Haisu; Liu, Jianxia; Xiong, Ling; Xu, Ying] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Anesthesiol, Minist Educ Key Lab Child Dev & Disorders,Children, 136 Zhongshan Er Rd, Chongqing 400014, Peoples R China; [Li, Haisu; Liu, Jianxia; Xiong, Ling; Xu, Ying] Chongqing Key Lab Child Neurodev & Cognit Disorder, Chongqing 400014, Peoples R China; [Duan, Guangyou] Chongqing Med Univ, Affiliated Hosp 2, Dept Anesthesiol, Chongqing 400010, Peoples R China"

通信作者："Xu, Y (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Anesthesiol, Minist Educ Key Lab Child Dev & Disorders,Children, 136 Zhongshan Er Rd, Chongqing 400014, Peoples R China.; Xu, Y (通讯作者)，Chongqing Key Lab Child Neurodev & Cognit Disorder, Chongqing 400014, Peoples R China."

来源：JOURNAL OF ANESTHESIA

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001234193700001

JCR分区：Q2

影响因子：2.8

年份：2024

卷号：38

期号：4

开始页：508

结束页：515

文献类型：Article

关键词：High-flow nasal cannula oxygen; Laryngeal surgery; Hyperoxemia; Oxygenation; Airway management

摘要："Purpose 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 PaO2 close to physiological levels while ensuring adequate oxygenation in surgery. Methods 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 PaO2, time weighted average fraction of inspired oxygen (FiO(2)), and mean Peripheral Oxygen Saturation (SpO(2)) were compared between groups. Finally, some analyses were conducted to examine the relationship of ORI with PaO2. Results In general, the postoperative PaO2 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(2) in the ORI group was 85.9 [81.8-92.7] %. There was no significant difference in mean SpO(2) 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 PaO2 was 150 mmHg. Conclusions In pediatric laryngeal surgery with HFNO, reducing oxygen concentration guided by ORI helped achieve postoperative PaO2 levels closer to physiological norms without compromising intra-operative oxygenation."

基金机构：Department of Anesthesiology at Children's Hospital of Chongqing Medical University

基金资助正文：We would like to express our heartfelt appreciation to the doctors and nurses from the Department of Anesthesiology at Children's Hospital of Chongqing Medical University for their unwavering support in this research. We are also immensely grateful to the dedicated research team and all the patients who participated in this study.