Can Noninvasive Oxygen Saturation Index Match Invasive Oxygenation Index to Monitor Respiratory Disease in Critically Ill Children?-A Prospective Study.

Abstract

Respiratory illnesses are common indications for mechanical ventilation in children. The adequacy of ventilatory support for oxygenation is measured using arterial blood gas analysis and calculation of oxygenation index (OI). Due to invasive nature of arterial blood sampling needed to calculate OI, several researchers have replaced blood gas-derived partial pressure of oxygen values with oxygen saturation (SpO ₂ ) obtained from pulse oximetry. This noninvasive index called oxygen saturation index (OSI) is found to be useful in neonates. Studies in pediatric population are lacking. In this prospective study on mechanically ventilated children, both OI and OSI were determined and compared against alveolar-arterial oxygen difference (AaDO ₂ ). A total of 29 children were studied. Both OSI and OI had good correlation of 0.787 and 0.792 with AaDO ₂ , respectively. OSI of 7.3 and 9.4 had good sensitivity and specificity for AaDO ₂ cutoffs of 344 and 498, which represents moderate and severe respiratory illness, respectively. The correlation coefficients of both OSI and OI are similar against AaDO ₂ . OSI can be used instead of OI for constant monitoring of children on mechanical ventilation. Arterial blood gas analysis and calculation of OI can be reserved for situations where SpO ₂ measurement is unreliable.