Oxygen reserve index vs. peripheral oxygen saturation for the prediction of hypoxemia in morbidly obese patients: a prospective observational study.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968535 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2253 (Electronic) Linking ISSN: 14712253 NLM ISO Abbreviation: BMC Anesthesiol Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BioMed Central, 2001-
    • Subject Terms:
      Obesity, Morbid*/complications ; Hypoxia*/blood ; Oximetry*/methods ; Oxygen Saturation*/physiology; Humans ; Prospective Studies ; Female ; Male ; Middle Aged ; Adult ; Oxygen/blood ; Intubation, Intratracheal/methods ; Aged
    • Abstract:
      Background: Pulse oximetry is a standart of anesthesia for perioperative monitoring. Due to the principles of Hb oxygen dissociation curve, peripheral oxygen saturation has an approximate sensitivity and specificity of 90% for the detection of hypoxemia.
      Objectives: The primary outcome of the study was to evaluate ORi Ⓡ as an early parameter to determine hypoxia in morbidly obese patients. The secondary outcome was to compare the effectiveness of ORi Ⓡ with SpO 2 in non-obese patients.
      Design: Prospective, observational study.
      Setting: Department of elective operating room at tertiary hospital.
      Patients and Methods: Observational study included written informed consent from 51 patients with 19 < BMI < 25 kg/m 2 and 51 patients with BMI > 40 kg/m 2 undergoing an elective surgery requiring tracheal intubation. In addition to standard monitors, an ORi sensor was placed and baseline values were recorded. The patients were preoxygenated until end tidal expiratory oxygen concentration is reached to 90%. After anesthesia induction and tracheal intubation, the breathing circuit was not connected tracheal tube until the SpO 2 decreased to 95%. Shapiro-Wilk, Pearson Chi-square, t-test, and Mann Whitney U test were used for the study.
      Main Outcome Measures: Times of tolerable apnea, ORi Ⓡ and SpO 2 values at the end of preoxygenation, beginning of intubation, beginning of the ORi alarm, when SpO 2 reached 95%, and when ORi reaches a plateau.
      Sample Size: 102 patients.
      Results: The alert period: time to reach ORi Ⓡ from 0.24 to a value of 95% SpO 2 was observed as 32 s in morbidly obese patients and 94 s in patients with a normal body mass index. The SpO 2 alert period was determined as time difference between 97% and 95% SpO 2 . The data were recorded as 15 s and 36 s, respectively. It was observed that tolerable apnea, ORi Ⓡ , SpO 2 and added alert times were longer in patients with normal BMI compared to morbidly obese patients.
      Conclusions: As a result, ORi Ⓡ can provide an early warning to prevent unexpected hypoxia before saturation begins to decrease in morbidly obese patients.
      Limitations: Inability to perform arterial blood gas sampling in the time periods when we looked at the parameters to determine the relationship between ORi Ⓡ and PaO 2 .
      Gov Identifier: NCT05480748 registered 2022-07-29.
      (© 2024. The Author(s).)
    • References:
      Anesth Analg. 2016 Sep;123(3):626-33. (PMID: 27007078)
      BMC Anesthesiol. 2015 Jul 04;15:97. (PMID: 26141622)
      Crit Care. 2015 Jun 17;19:258. (PMID: 26082175)
      PLoS One. 2018 Jul 5;13(7):e0199610. (PMID: 29975721)
      World J Emerg Med. 2014;5(4):279-85. (PMID: 25548602)
      Am J Respir Crit Care Med. 2006 Jul 15;174(2):171-7. (PMID: 16627862)
      Minerva Anestesiol. 2018 Sep;84(9):1063-1069. (PMID: 29756744)
      J Clin Monit Comput. 2020 Jun;34(3):509-514. (PMID: 31227971)
      Crit Care. 2015 Jul 16;19:272. (PMID: 26179876)
      J Clin Monit Comput. 2022 Oct;36(5):1341-1346. (PMID: 34705168)
      Intensive Crit Care Nurs. 2002 Apr;18(2):79-89. (PMID: 12353655)
      J Clin Monit Comput. 2018 Jun;32(3):379-389. (PMID: 28791567)
      Minerva Anestesiol. 2015 Aug;81(8):910-20. (PMID: 26044934)
      Can J Anaesth. 2013 Sep;60(9):929-45. (PMID: 23836064)
      Anesth Analg. 2021 Mar 1;132(3):770-776. (PMID: 32815872)
      J Clin Monit Comput. 2018 Aug;32(4):687-691. (PMID: 28956237)
      Anesth Analg. 2019 Aug;129(2):409-415. (PMID: 30138170)
      Anesth Essays Res. 2020 Oct-Dec;14(4):594-599. (PMID: 34349326)
      J Clin Monit Comput. 2021 Aug;35(4):749-756. (PMID: 32424516)
      Anesthesiology. 2016 Apr;124(4):779-84. (PMID: 26978143)
      J Anaesthesiol Clin Pharmacol. 2020 Jan-Mar;36(1):125-126. (PMID: 32174677)
      J Clin Monit Comput. 2022 Oct;36(5):1379-1385. (PMID: 34953137)
    • Contributed Indexing:
      Keywords: Hypoxemia; Morbidly obese patients; Oxygen reserve index; Oxygen reserve index warning time; Percutaneous oxygen saturation warning time; Tolerable apnea time
    • Molecular Sequence:
      ClinicalTrials.gov NCT05480748
    • Accession Number:
      S88TT14065 (Oxygen)
    • Publication Date:
      Date Created: 20241011 Date Completed: 20241011 Latest Revision: 20241108
    • Publication Date:
      20241109
    • Accession Number:
      PMC11468122
    • Accession Number:
      10.1186/s12871-024-02755-8
    • Accession Number:
      39394112