Editorial Views  |   April 2016
When Seconds Count, Buy More Time: The Oxygen Reserve Index and Its Promising Role in Patient Monitoring and Safety
Author Notes
  • From the Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Corresponding article on page 779.
    Corresponding article on page 779.×
  • Accepted for publication December 29, 2015.
    Accepted for publication December 29, 2015.×
  • Address correspondence to Dr. Simpao: simpaoa@email.chop.edu
Article Information
Editorial Views / Respiratory System
Editorial Views   |   April 2016
When Seconds Count, Buy More Time: The Oxygen Reserve Index and Its Promising Role in Patient Monitoring and Safety
Anesthesiology 4 2016, Vol.124, 750-751. doi:10.1097/ALN.0000000000001036
Anesthesiology 4 2016, Vol.124, 750-751. doi:10.1097/ALN.0000000000001036
THE pulse oximeter has become a virtually indispensable monitor for measuring a patient’s peripheral capillary oxygen saturation (Spo2) accurately and reliably in a continuous, noninvasive fashion.1  Despite its ubiquitous use as a detector of hypoxemia, pulse oximetry has limited utility to herald an oxygen desaturation event until the partial pressure of oxygen (Pao2) falls below 80 mmHg. Above this threshold, a patient’s Spo2 will typically remain at or near 100%, whereas Pao2 drops; by the time the Spo2 falls, the patient’s Pao2 may be accelerating quickly past the inflection point of the oxygen–hemoglobin dissociation curve and proceed to decrease rapidly.2  In this issue of Anesthesiology, Szmuk et al.3  present a pilot study of the oxygen reserve index (ORI), a novel pulse oximeter–based nondimensional index that may provide a clinically important warning of impending desaturation in patients who have increased Pao2 levels. The authors report results from a prospective clinical trial in children that measured ORI after preoxygenation, induction of general anesthesia, successful tracheal intubation, and then disconnection of the anesthesia circuit. Their major finding was that the ORI indicated impending desaturation at a median of 31.5 s (interquartile range, 19 to 34.3 s) before noticeable changes in Spo2 occurred.
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