Journal Article Ahead of print 1 citation
PubMed: 42303220 DOI: 10.1016/j.jpeds.2026.115200
Correlation of Oxygen Saturation Index with Oxygenation Index in Congenital Diaphragmatic Hernia: in A Secondary Analysis of a Randomized Clinical Trial.
J Pediatr
Authors: Satyan Lakshminrusimha, Bradley A Yoder, Dhuly Chowdhury, Abhik Das, Haresh Kirpalani, Megan A Dhawan, Jonathan M Snyder, María V Fraga, Ganesh G Konduri, Patrick J McNamara, Jonathan Klein, Namasivayam Ambalavanan, Carrie A Rau, Kevin P Lally, Leif D Nelin, C Michael Cotten, Rosemary D Higgins, Martin Keszler
Affiliations
- Department of Pediatrics, University of California at Davis Children's Hospital, Sacramento, CA 95817.
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84108.
- RTI International, Research Triangle Park, North Carolina.
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104.
- Department of Pediatrics, Medical College of Wisconsin and Children's Research Institute, Children's Wisconsin, Milwaukee, WI, 53226.
- Department of Pediatrics, University of Iowa, Iowa City IA.
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35249.
- Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston and Children's Memorial Hermann Hospital, Houston, TX, USA.
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.
- Department of Pediatrics, Duke University, Durham, NC.
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; Research and Sponsored Programs, Florida Gulf Coast University, Fort Myers, FL.
- Department of Pediatrics, The Alpert Medical School of Brown University, Providence, RI.
Abstract
OBJECTIVE
To assess accuracy of prediction of oxygenation index (OI=mean airway pressure*FiO 2*100÷PaO 2) with a non-invasive alternative, oxygen saturation index (OSI= FiO 2*100÷SpO 2) in a prospectively collected multicenter cohort of children with congenital diaphragmatic hernia (CDH) with substantial degree of hypoxemia (OI≥10 or OSI≥5).
STUDY DESIGN
This secondary analysis of the Milrinone in CDH Trial studied 61 subjects with OI≥10 or OSI≥5 at randomization. Prospectively collected arterial blood gas (ABG) data with PaO 2 and preductal and postductal SpO 2 were used to compare all OI and preductal OSI, all OI and postductal OSI, preductal OI/OSI only and postductal OI/OSI, by simple linear and quadratic regression modelling.
RESULTS
Indwelling arterial lines were present in 61 of 66 randomized subjects (51 as umbilical arterial lines). There were 572 matched pairs of PaO 2-SpO 2 data. Repeated measures correlation (95% CI) between all OI and preductal OSI by linear regression was 0.82 (0.79,0.85; n=61 patients, 572 samples), and between OI and OSI with SpO 2 matched from the same preductal or postductal sites as the ABG were 0.97 (9.91,0.89) and 0.86 (0.84,0.89) respectively. The relationship between preductal OI and OSI was described best by the quadratic equation, OI=0.3*OSI+0.1*OSI 2+2.4 (4 patients, 22 samples) and postductal OI and OSI by OI=0.6*OSI +0.08*OSI 2+2.6 (54 patients, 477 samples). There was no difference in quasi-likelihood under the independence model information criterion (QlCu) between linear and quadratic models (461 vs 462 respectively). Use of site-specific (preductal vs postductal) quadratic equations captured the non-linear relationship but did not improve QlCu.
CONCLUSION
Non-invasive OSI values correlate well with OI. The use of OSI based on preductal SpO 2 may be a suitable alternate strategy for clinical trials even if post-ductal arterial access is available.
MeSH
Hernia, Hypertension, Pulmonary, Hernias, Diaphragmatic, Congenital, Hypoxia, Pediatrics, Hernia, Diaphragmatic, Oxygen Saturation