{"title":"在小儿喉部手术中使用高流量鼻插管供氧时，以氧储备指数指导氧气浓度滴定：随机对照试验。","authors":"Haisu Li, Jianxia Liu, Ling Xiong, Guangyou Duan, Ying Xu","doi":"10.1007/s00540-024-03348-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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 PaO<sub>2</sub> close to physiological levels while ensuring adequate oxygenation in surgery.</p><p><strong>Methods: </strong>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 PaO<sub>2</sub>, time weighted average fraction of inspired oxygen (FiO<sub>2</sub>), and mean Peripheral Oxygen Saturation (SpO<sub>2</sub>) were compared between groups. Finally, some analyses were conducted to examine the relationship of ORI with PaO<sub>2</sub>.</p><p><strong>Results: </strong>In general, the postoperative PaO<sub>2</sub> 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<sub>2</sub> in the ORI group was 85.9 [81.8-92.7] %. There was no significant difference in mean SpO<sub>2</sub> 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 PaO<sub>2</sub> was 150 mmHg.</p><p><strong>Conclusions: </strong>In pediatric laryngeal surgery with HFNO, reducing oxygen concentration guided by ORI helped achieve postoperative PaO<sub>2</sub> levels closer to physiological norms without compromising intra-operative oxygenation.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Oxygen concentration titration guided by oxygen reserve index during pediatric laryngeal surgery with high-flow nasal cannula oxygen: a randomized controlled trial.\",\"authors\":\"Haisu Li, Jianxia Liu, Ling Xiong, Guangyou Duan, Ying Xu\",\"doi\":\"10.1007/s00540-024-03348-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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 PaO<sub>2</sub> close to physiological levels while ensuring adequate oxygenation in surgery.</p><p><strong>Methods: </strong>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 PaO<sub>2</sub>, time weighted average fraction of inspired oxygen (FiO<sub>2</sub>), and mean Peripheral Oxygen Saturation (SpO<sub>2</sub>) were compared between groups. Finally, some analyses were conducted to examine the relationship of ORI with PaO<sub>2</sub>.</p><p><strong>Results: </strong>In general, the postoperative PaO<sub>2</sub> 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<sub>2</sub> in the ORI group was 85.9 [81.8-92.7] %. There was no significant difference in mean SpO<sub>2</sub> 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 PaO<sub>2</sub> was 150 mmHg.</p><p><strong>Conclusions: </strong>In pediatric laryngeal surgery with HFNO, reducing oxygen concentration guided by ORI helped achieve postoperative PaO<sub>2</sub> levels closer to physiological norms without compromising intra-operative oxygenation.</p>\",\"PeriodicalId\":14997,\"journal\":{\"name\":\"Journal of Anesthesia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Anesthesia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00540-024-03348-y\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Anesthesia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00540-024-03348-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在评估在小儿喉部手术中使用高流量鼻导管供氧（HFNO）时，根据氧储备指数（ORI）调整氧气浓度是否能使术后 PaO2 接近生理水平，同时确保手术中的充分氧合：将接受喉部手术或检查的 60 名儿童患者随机分为两组。ORI 组每 5 分钟调整一次氧气浓度，以维持 0.21 的目标 ORI 值，而对照组则不做任何调整。对两组的术后 PaO2、时间加权平均吸入氧分数（FiO2）和平均外周血氧饱和度（SpO2）进行比较。最后，对 ORI 与 PaO2 的关系进行了一些分析：总体而言，ORI 组的术后 PaO2 为 164.9 ± 48.8 mmHg，对照组为 323.0 ± 87.7 mmHg（ORI 组的 P 2 为 85.9 [81.8-92.7] %）。两组的平均 SpO2 无明显差异（ORI 组 vs. 对照组：98.4 [97.7-99.2] vs. 98.8 [97.7-99.5]; P = 0.36）。根据分析，当PaO2为150 mmHg时，ORI的最佳切点值为0.195：结论：在使用高频硝化氧的小儿喉部手术中，以ORI为指导降低氧浓度有助于使术后PaO2水平更接近生理标准，同时不影响术中氧合。
Oxygen concentration titration guided by oxygen reserve index during pediatric laryngeal surgery with high-flow nasal cannula oxygen: a randomized controlled trial.
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 (FiO2), and mean Peripheral Oxygen Saturation (SpO2) 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 FiO2 in the ORI group was 85.9 [81.8-92.7] %. There was no significant difference in mean SpO2 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.
期刊介绍：
The Journal of Anesthesia is the official journal of the Japanese Society of Anesthesiologists. This journal publishes original articles, review articles, special articles, clinical reports, short communications, letters to the editor, and book and multimedia reviews. The editors welcome the submission of manuscripts devoted to anesthesia and related topics from any country of the world. Membership in the Society is not a prerequisite.
The Journal of Anesthesia (JA) welcomes case reports that show unique cases in perioperative medicine, intensive care, emergency medicine, and pain management.
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