The Effectiveness of FiO2 Titration Guided by the Oxygen Reserve Index in Preventing Hyperoxia.

Tepecik Training and Research Hospital62 enrolled

Overview

Oxygen therapy is the most common treatment modality for patients with hypoxemia, but target values for normoxemia are not clearly defined. Therefore, iatrogenic hyperoxemia is a very common situation. Even though there are many side effects reported related to hyperoxemia and hyperoxemia is shown to be related to worse outcome than expected; clinicians still observe hyperoxemia frequently. Oxygen reserve index (ORi™) (Masimo Corp., Irvine, USA) can guide clinicians in detection of hyperoxia. ORi is a parameter which can evaluate partial pressure of oxygen (PaO2) rating from 0 to 1. There are growing evidences in ORi that it might be helpful to reduce hyperoxia in general anesthesia. Continuous ORi monitoring can be used for detecting and preventing hyperoxia. The ability to perform FiO2 titration with ORi may be an appropriate monitoring management to prevent the harmful effects of hyperoxia.In this study, in patients who underwent major abdominal surgery; It was aimed to investigate the effectiveness of ORi-guided FiO2 titration in preventing hyperoxia.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Enrollment

Conditions

Hyperoxia Complication

Titration of fraction of inspired oxygen (FiO2) guided by ORI and oxygen saturationPROCEDURE

* FiO2 will be titrated by reducing 10% if Ori\>0.01 and oxygen saturation ≥ 98% until Ori is 0.00. * FiO2 will not be changed if Ori is 0.00 and %95\<oxygen saturation≤%98 * FiO2 will be increased by 10% if oxygen saturation \<95 or PaO2\<60 mmHg

SpO2 (oxygen saturation)PROCEDURE

Fraction of inspired oxygen (FiO2) is titrated guided by oxygen saturation in that range; %95\<oxygen saturation≤%98

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients older than 18, 2. Patients scheduled for major abdominal surgery that are expected to last longer than 2 hours 3. Patients that have invasive arterial monitorization 4. American Society of Anesthesiologists physical class I, II or III. Exclusion Criteria: 1. Patients younger than 18 2. Patients that need to be treated with high doses of vasopressors, 3. Patients having peripheric hypoperfusion, 4. Hemodynamically unstable patients, 5. Patients with hemoglobinopathy, 6. Pregnancy, 7. Morbid obesity (bmi\>40 kg/m2), 8. Patients with arrythmia that can result in hemodynamic instability, patients with acute coronary syndrome 9. Acute respiratory failure or ARDS.

Outcomes

Primary Outcomes

Correlation of FiO2 and ORi value

Correlation of FiO2 value and ORi value. FiO2 adjusted until ORi reaches to zero and %95\<oxygen saturation≤%98

Time frame: Until the surgery is over

Correlation of PaO2 and ORİ value

Pressure of arterial oxygen is obtain from arterial blood gas analysis as usual practice in 10 min and every hour until surgery is over

Time frame: Until surgery is over