Oxygen Saturation Index in Neonates with a Congenital Diaphragmatic Hernia: A Retrospective Cohort Study

Horn-Oudshoorn, Emily J J; Vermeulen, Marijn J.; Crossley, Kelly J.; Otter, Suzan C M Cochius-den; Schnater, J. Marco; Reiss, Irwin K M; DeKoninck, Philip

doi:10.1159/000520883

Cited by 9 publications

(15 citation statements)

References 20 publications

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“…An OSI value ≥22 is strongly associated with both the need for ECMO-therapy and mortality, both of which are in accordance with previous findings. We speculate that individualizing and intensifying therapy in the OSI range between 12.5 and 22 might avoid further clinical deterioration [14]. However, more evaluation of this concept is warranted.…”

Section: Discussionmentioning

confidence: 99%

“…We have previously shown comparable predictive values of OSI values equivalent to the OI values that are currently used to decide on upscaling therapy such as ECMO [12, 14]. However, the main advantage of continuous OSI measurements is that it may provide early warnings of clinical deterioration, thus allowing for preventive measures rather than adjusting treatment at the moment that clinical deterioration has already occurred.…”

Section: Discussionmentioning

confidence: 99%

“…We conducted a single-center retrospective cohort study at the Erasmus MC, University Medical Center (Rotterdam, The Netherlands). Eligible cases were added to an existing database that was used in a recent study [14]. All consecutive infants born with a prenatally detected isolated left-sided or right-sided CDH between June 2017 and July 2021 were included.…”

Section: Methodsmentioning

confidence: 99%

“…As the OSI could be monitored continuously and transcutaneously, in contrast to the commonly used OI that requires blood sampling, the OSI might be used for real-time and bedside guidance during the crucial first hours of life. We have recently demonstrated that both the OI and OSI predict adverse outcomes in infants with CDH, but up until now, studies have focused on either the predictive value of OSI measurements at pre-specified time points or the comparability of paired OI and OSI measurements [9][10][11][12][13][14][15]. Hence, studies on the predictive value of continuous OSI measurements are scarce, especially in infants with CDH [16].…”

Section: Introductionmentioning

confidence: 99%

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The Oxygen Saturation Index as Early Predictor of Outcomes in Congenital Diaphragmatic Hernia

et al. 2022

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Objective: The aim of the study was to evaluate the oxygen saturation index (OSI) as an early predictor of clinical deterioration in infants with congenital diaphragmatic hernia (CDH). Methods: A single-center retrospective cohort study was conducted in consecutive infants with isolated CDH with continuous OSI measurements collected in the first 24 h after birth between June 2017 and July 2021. Outcomes of interest were pulmonary hypertension, extracorporeal membrane oxygenation (ECMO)-therapy, and mortality. We evaluated the discriminative values of the maximum OSI value and of mean OSI values with receiver operator characteristic (ROC) analysis and the area under the ROC curve. Results: In 42 infants with 49,473 OSI measurements, the median OSI was 5.0 (interquartile range 3.1–10.6). Twenty-seven infants developed pulmonary hypertension on a median of day 1 (1-1), of which 15 infants had an indication for ECMO-therapy, and 6 infants died. Maximum OSI values were associated with pulmonary hypertension, ECMO-therapy, and mortality. Mean OSI values had an acceptable discriminative ability for pulmonary hypertension and an excellent discriminative ability for ECMO-therapy and mortality. Although OSI measurements were not always present in the first hours after birth, we determined discriminative cut-offs for mean OSI values already in these first hours for pulmonary hypertension, the need for ECMO-therapy, and mortality. Conclusions: Continuous OSI evaluation is a promising modality to identify those infants at highest risk for clinical deterioration already in the first hours after birth. This provides an opportunity to tailor postnatal management based on the individual patient’s needs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Oxygen Saturation Index as Early Predictor of Outcomes in Congenital Diaphragmatic Hernia

et al. 2022

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“…Oxygen saturation index was measured through equation: (OSI= MAP X FIO2 X 100/ spO2) Where MAP (mean airway pressure) and FIo2 (fraction of inspired oxygen) measured from ventilator display and spO2 measured from monitor display by Continuous SpO2 monitoring was done using pulse oximeter (SAT-2200 oxypal mini, Nihon Kohden Corporation) a sensor is placed over a digit (10) .…”

Section: The Participants Were Randomly Assigned Into Two Equal Groupsmentioning

confidence: 99%

Effect of Thoracic Block Technique on Atelectasis in Children on Mechanical Ventilation

Ashary¹,

Hazem²,

Ibrahim³

2022

The Egyptian Journal of Hospital Medicine

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Background: Atelectasis is described as lung collapse that affects one or more regions of the lung. It is characterized by reducing lung volumes, altering the ventilation/perfusion ratio, and being one of the causes of delaying the weaning from mechanical ventilation. The aim of the present study was to investigate the effect of thoracic block technique on atelectasis in children on mechanical ventilation. Patients and methods: A total of 44 children with unilateral atelectasis on mechanical ventilation, from both gender and their ages ranged from 6 months to 4 years, were recruited from intensive care unit (ICU), Abo-Elreesh Hospital, Cairo University. Patients were randomly assigned into two groups; Group A included 22 children who received a designed chest physical therapy program, and Group B included 22 children who received a designed chest physical therapy program and thoracic block technique. Results: A significant increase in the percentage of totally improved lobes of lung in chest X-ray in both groups; the increase was significantly higher in patients who received a designed chest physical therapy program and thoracic block technique than patients who only received a designed chest physical therapy program (P=0.04). There was no significant difference in oxygen saturation index between groups post treatment (P=0.38). Conclusion:Applying thoracic block technique on mechanically ventilated children with atelectasis can produce a significant increase in the percentage of totally improved lobes of lung.

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Implementation of the Oxygen Saturation Index as a Predictor of Outcome in Prenatally Diagnosed CDH Neonates in the First 24 Hours of Life

Hale,

Leyens,

et al. 2024

Pediatric Pulmonology

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AimsThis study aimed to evaluate the Oxygen Saturation Index (OSI) as a noninvasive measure for early postnatal management and outcome prediction in neonates with congenital diaphragmatic hernia (CDH). Additionally, the study analyzed the correlation and predictive ability of OSI, Oxygenation Index (OI), Horovitz Index (HI), and partial pressure of arterial oxygen (PaO2) regarding mortality and the need for extracorporeal membrane oxygenation (ECMO).MethodsA retrospective, single‐center study using data from 2013 to 2020. Parameters for calculating indices were extracted from patient charts every hour during the first 24 h of life. Statistical analyses included ROC analysis for predictive cut‐off values and Spearman's rank for correlation assessments.ResultsThe study included 138 neonates. Postductal OSI demonstrated high sensitivity (80%–85%) and negative predictive value (NPV) for predicting mortality and ECMO need, with cut‐off values between 11.5 and 13. Optimal cut‐off values for predicting ECMO need were 10 at 12 and 24 h (sensitivity 96.7%). OSI, OI, HI, and PaO2 showed comparable predictive capabilities with strong correlations. The lowest OI of 18 predicted mortality with a sensitivity of 75% and specificity of 90.9%. Strong correlations were found between the lowest PaO2 and lowest HI (0.963–0.974), and between highest OI and lowest PaO2 (−0.922 to −0.945).ConclusionOSI is a promising index for predicting outcomes in CDH neonates, showing strong correlation with indices like OI and HI. Despite limitations, OSI provides continuous, bedside monitoring without invasive blood sampling. Further prospective studies are needed to validate these findings and establish new cut‐off values.

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Oxygen Saturation Index in Neonates with a Congenital Diaphragmatic Hernia: A Retrospective Cohort Study

Cited by 9 publications

References 20 publications

The Oxygen Saturation Index as Early Predictor of Outcomes in Congenital Diaphragmatic Hernia

The Oxygen Saturation Index as Early Predictor of Outcomes in Congenital Diaphragmatic Hernia

Effect of Thoracic Block Technique on Atelectasis in Children on Mechanical Ventilation

Implementation of the Oxygen Saturation Index as a Predictor of Outcome in Prenatally Diagnosed CDH Neonates in the First 24 Hours of Life

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