REVIEW PAPER
Usefulness of oxygen reserve index (ORi) in clinical practice
1
Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lodz, Poland
Submission date: 2023-07-25
Final revision date: 2023-10-17
Acceptance date: 2023-10-23
Publication date: 2023-12-30
Corresponding author
Małgorzata Barud
Małgorzata Barud MD, PhD Department of Anaesthesiology and Intensive Therapy Medical University of Lublin Lublin, Poland
Małgorzata Barud MD, PhD Department of Anaesthesiology and Intensive Therapy Medical University of Lublin Lublin, Poland
Medical Studies 2023;39(4):381-388
KEYWORDS
TOPICS
ABSTRACT
Oxygen is the most common and widely used drug. Oxygen therapy is used not only among mechanically ventilated patients in intensive care units, but also in the perioperative period and in patients requiring oxygen supplementation in other hospital wards. The main methods of monitoring the blood oxygenation level include arterial blood gases and pulse oximetry. A new parameter that allows the monitoring of patients’ oxygenation status is the oxygen reserve index (ORi). The ORi provides easy, non-invasive, bedside monitoring of oxygen reserve capacity. The oxygen reserve index reflects the partial pressure of oxygen in arterial blood (PaO2) in the range 100–200 mm Hg. It therefore allows the detection of mild hyperoxia, enabling the safe use of lower concentrations of oxygen in the breathing mixture. It is also a useful tool in predicting impending hypoxia. This paper summarizes the usefulness of oxygen reserve index monitoring in various clinical situations in everyday anaesthesiology practice.
REFERENCES (70)
1.
Samaja M, Ottolenghi S. The oxygen cascade from atmosphere to mitochondria as a tool to understand the (mal)adaptation to hypoxia. Int J Mol Sci 2023; 24: 3670-3706.
2.
Damiani E, Donati A, Girardis M. Oxygen in the critically ill: friend or foe? Curr Opin Anaesthesiol 2018; 31: 129-135.
4.
Helmerhorst HJ, Arts DL, Schultz MJ, van der Voort PH, Abu-Hanna A, de Jonge E, van Westerloo DJ. Metrics of arterial hyperoxia and associated outcomes in critical care. Crit Care Med 2017; 45: 187-195.
5.
Munshi L, Kiss A, Cypel M, Keshavjee S, Ferguson ND, Fan E. Oxygen thersold and mortality during extracorporeal life support in adult patients. Crit Care Med 2017; 45: 1997-2005.
6.
Chandran J, D’Silva C, Sriram S, Krishna B. Clinical utility of arterial blood gas test in an intensive care unit: an observational study. Indian J Crit Care Med 2021; 25: 172-175.
7.
Lian JX. Interpreting and using the arterial blood gas analysis. Nurs Crit Care 2010; 5: 26-36.
8.
Castro D, Patil SM, Keenaghan M. Arterial Blood Gas. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. 2022 Sep 1.
9.
Ganter MT, Schneider U, Heinzelmann M, Zaugg M, Lucchinetti E, Zollinger A, Hofer CK. How often should we perform arterial blood gas analysis during thoracoscopic surgery? J Clin Anesth 2007; 19: 569-575.
10.
Quintard H, Patet C, Suys T, Marques-Vidal P, Oddo M. Normobaric hyperoxia is associated with increased cerebral excitotoxicity after severe traumatic brain injury. Neurocrit Care 2015; 22: 243-250.
11.
Vincent JL, Taccone FS, He X. Harmful effects of hyperoxia in postcardiac arrest, sepsis, traumatic brain injury, or stroke: the importance of individualized oxygen therapy in critically ill patients. Can Respir J 2017; 2017: 2834956.
12.
Aoyagi T. Pulse oximetry: its invention, theory, and future. J Anesth 2003; 17: 259-266.
13.
Luks AM, Swenson ER. Pulse oximetry for monitoring patients with COVID-19 at home. Potential pitfalls and practical guidance. Ann Am Thorac Soc 2020; 17: 1040-1046.
14.
Scheeren TWL, Belda FJ, Perel A. The oxygen reserve index (ORI): a new tool to monitor oxygen therapy. J Clin Monit Comput 2018; 32: 379-389.
15.
Ishida Y, Okada T, Kobayashi T, Uchino H. ORi™: a new indicator of oxygenation. J Anesth 2021; 35: 734-740.
16.
Applegate RL 2nd, Dorotta IL, Wells B, Juma D, Applegate PM. The relationship between oxygen reserve index and arterial partial pressure of oxygen during surgery. Anesth Analg 2016; 123: 626-633.
17.
Vos JJ, Willems CH, van Amsterdam K, van den Berg JP, Spanjersberg R, Struys MMRF, Scheeren TWL. Oxygen Reserve Index: validation of a new variable. Anesth Analg 2019; 129: 409-415.
18.
Kumagai M, Kurihara H, Ishida K, Komatsu H, Suzuki K. The Oxygen Reserve Index as a determinant of the necessary amount of postoperative supplemental oxygen. Minerva Anestesiol 2021; 87: 439-447.
19.
Ray S, Kulkarni KS, Dave NM, Chincholi I. The utility of the oxygen reserve index™ in a neonate undergoing re-exploration of a tracheoesophageal fistula. Indian J Anaesth 2018; 62: 233-234.
20.
Reich B, Hoeber D, Bendix I, Felderhoff-Mueser U. Hyperoxia and the immature brain. Dev Neurosci 2016; 38: 311-330.
21.
Shimizu N, Ogiwara S, Saito O. Usefulness of monitoring the oxygen reserve index in the pediatric intensive care unit. Chiba Medical J 2019; 95E: 7-9.
22.
Singer M, Young PJ, Laffey JG, Asfar P, Taccone FS, Skrifvars MB, Meyhoff CS, Radermacher P. Dangers of hyperoxia. Crit Care 2021; 25: 440-454.
23.
Nathan C, Cunningham-Bussel A. Beyond oxidative stress: an immunologist’s guide to reactive oxygen species. Nat Rev Immunol 2013; 13: 349-361.
24.
Helmerhorst HJ, Schultz MJ, van der Voort PH, de Jonge E, van Westerloo DJ. Bench-to-bedside review: the effects of hyperoxia during critical illness. Crit Care 2015; 19: 284-295.
25.
Di Donato S. Wieloukładowe objawy chorób mitochondrialnych. Neurologia po Dyplomie 2010; 5: 21-36.
26.
Rattan SI. Theories of biological aging: genes, proteins, and free radicals. Free Radic Res 2006; 40: 1230-1238.
27.
Rothen H, Sporre B, Engberg G, Wegenius G, Reber A, Hedenstierna G. Prevention of atelectasis during general anaesthesia. Lancet 1995; 345: 1387-1391.
28.
Edmark L, Kostova-Aherdan K, Enlund M, Hedenstierna G. Optimal oxygen concentration during induction of general anesthesia. Anesthesiology 2003; 98: 28-33.
29.
Hedenstierna G, Edmar L. Mechanisms of atelectasis in the perioperative period. Best Pract Res Clin Anaesthesiol 2010; 24: 157-169.
30.
Staehr-Rye AK, Meyhoff CS, Scheffenbichler FT, Vidal Melo MF, Gätke MR, Walsh JL, Ladha KS, Grabitz SD, Nikolov MI, Kurth T, Rasmussen LS, Eikermann M. High intraoperative inspiratory oxygen fraction and risk of major respiratory complications. Br J Anaesth 2017; 119: 140-149.
31.
Horncastle E, Lumb AB. Hyperoxia in anaesthesia and intensive care. BJA Educ 2019; 19: 176-182.
32.
Haque WA, Boehmer J, Clemson BS, Leuenberger UA, Silber DH, Sinoway LI. Hemodynamic effects of supplemental oxygen administration in congestive heart failure. J Am Coll Cardiol 1996; 27: 353-357.
33.
Stolmeijer R, van Ieperen E, Lameijer H, van Beest P, Ter Maaten JC, Ter Avest E. Haemodynamic effects of a 10-min treatment with a high inspired oxygen concentration in the emergency department: a prospective observational study. BMJ Open 2022; 12: e059848.
34.
Lund VE, Kentala E, Scheinin H, Klossner J, Helenius H, Sariola-Heinonen K, Jalonen J. Heart rate variability in healthy volunteers during normobaric and hyperbaric hyperoxia. Acta Physiol Scand 1999; 167: 29-35.
35.
Sjoberg F, Singer M. The medical use of oxygen: a time for critical reappraisal. J Intern Med 2013; 274: 505-528.
36.
Farquhar H, Weatherall M, Wijesinghe M, Perrin K, Ranchord A, Simmonds M, Beasley R. Systematic review of studies of the effect of hyperoxia on coronary blood flow. Am Heart J 2009; 158: 371-377.
37.
Mak S, Azevedo ER, Liu PP, Newton GE. Effect of hyperoxia on left ventricular function and filling pressures in patients with and without congestive heart failure. Chest 2001; 120: 467-473.
38.
Rincon F, Kang J, Vibbert M, Urtecho J, Athar MK, Jallo J. Significance of arterial hyperoxia and relationship with case fatality in traumatic brain injury; a multicentre cohort study. J Neurol Neurosurg Psychiatry 2014; 85: 799-805.
39.
Rincon F, Kang J, Maltenfort M, Vibbert M, Urtecho J, Athar MK, Jallo J, Pineda CC, Tzeng D, McBride W, Bell R. Association between hyperoxia and mortality after stroke: a multicenter cohort study. Crit Care Med 2014; 42: 387-396.
40.
Bellomo R, Bailey M, Eastwood GM, Nichol A, Pilcher D, Hart GK, Reade MC, Egi M, Cooper DJ; Study of Oxygen in Critical Care (SOCC) Group. Arterial hyperoxia and in-hospital mortality after resuscitation from cardiac arrest. Crit Care 2011; 15: R90-R98.
41.
Girardis M, Busani S, Damiani E, Donati A, Rinaldi L, Marudi A, Morelli A, Antonelli M, Singer M. Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA 2016; 316: 1583-1589.
42.
de Jonge E, Peelen L, Keijzers PJ, Joore H, de Lange D, van der Voort PH, Bosman RJ, de Waal RA, Wesselink R, de Keizer NF. Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients. Crit Care 2008; 12: R156-R163.
43.
Meyhoff CS, Jorgensen LN, Wetterslev J, Christensen KB, Rasmussen LS; PROXI Trial Group. Increased long-term mortality after a high perioperative inspiratory oxygen fraction during abdominal surgery: follow-up of a randomized clinical trial. Anesth Analg 2012; 115: 849-854.
44.
Xu F, Liu P, Pascual JM, Xiao G, Lu H. Effect of hypoxia and hyperoxia on cerebral blood flow, blood oxygenation, and oxidative metabolism. J Cereb Blood Flow Metab 2012; 32: 1909-1918.
45.
Richards EM, Fiskum G, Rosenthal RE, Hopkins I, McKenna MC. Hyperoxic reperfusion after global ischemia decreases hippocampal energy metabolism. Stroke 2007; 38: 1578-1584.
46.
Sheng M, Liu P, Mao D, Ge Y, Lu H. The impact of hyperoxia on brain activity: a resting-state and task-evoked electroencephalography (EEG) study. PLoS One 2017; 12: E0176610.
47.
Bickford PC, Chadman K, Williams B, Shukitt-Hale B, Holmes D, Taglialatela G, Joseph J. Effect of normobaric hyperoxia on two indexes of synaptic function in Fisher 344 rats. Free Radic Biol Med 1999; 26: 817-824.
48.
Wilson DF, Matschinsky FM. Hyperbaric oxygen toxicity in brain: a case of hyperoxia induced hypoglycemic brain syndrome. Med Hypotheses 2019; 132: 109375.
49.
Dabrowski W, Siwicka-Gieroba D, Gasinska-Blotniak M, Zaid S, Jezierska M, Pakulski C, Williams Roberson S, Wesley Ely E, Kotfis K. Pathomechanisms of non-traumatic acute brain injury in critically ill patients. Medicina (Kaunas) 2020; 56: 469-485.
50.
Kupiec A, Adamik B, Forkasiewicz-Gardynik K, Goździk W. Intra-operative hyperoxia and the risk of delirium in elderly patients after cardiac surgery. Aging (Albany NY) 2020; 12: 7006-7014.
51.
Mutch WAC, El-Gabalawy R, Ryner L, Puig J, Essig M, Kilborn K, Fidler K, Graham MR. Brain BOLD MRI O2 and CO2 stress testing: implications for perioperative neurocognitive disorder following surgery. Crit Care 2020; 24: 76-88.
52.
Brenner M, Stein D, Hu P, Kufera J, Wooford M, Scalea T. Association between early hyperoxia and worse outcomes after traumatic brain injury. Arch Surg 2012; 147: 1042-1046.
53.
Chu DK, Kim LH, Young PJ, Zamiri N, Almenawer SA, Jaeschke R, Szczeklik W, Schünemann HJ, Neary JD, Alhazzani W. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet 2018; 391: 1693-1705.
54.
van den Boom W, Hoy M, Sankaran J, Liu M, Chahed H, Feng M, See KC. The search for optimal oxygen saturation targets in critically ill patients: observational data from large ICU databases. Chest 2020; 157: 566-573.
55.
Yoshida K, Isosu T, Noji Y, Ebana H, Honda J, Sanbe N, Obara S, Murakawa M. Adjustment of oxygen reserve index (ORi™) to avoid excessive hyperoxia during general anesthesia. J Clin Monit Comput 2020; 34: 509-514.
56.
Ahn JH, Shim JG, Park J, Lee SH, Ryu KH, Cho EA. Oxygen reserve index guided fraction of inspired oxygen titration to reduce hyperoxemia during laparoscopic gastrectomy: a randomized controlled trial. Medicine (Baltimore) 2022; 101: e31592.
57.
de Courson H, Julien-Laferrière T, Georges D, Boyer P, Verchère E, Biais M. The ability of Oxygen Reserve Index® to detect hyperoxia in critically ill patients. Ann Intensive Care 2022; 12: 40-47.
58.
Fleming NW, Singh A, Lee L, Applegate RL 2nd. Oxygen Reserve Index: utility as an early warning for desaturation in high-risk surgical patients. Anesth Analg 2021; 132: 770-776.
59.
Tsymbal E, Ayala S, Singh A, Applegate RL 2nd, Fleming NW. Study of early warning for desaturation provided by Oxygen Reserve Index in obese patients. J Clin Monit Comput 2021; 35: 749-756.
60.
Szmuk P, Steiner JW, Olomu PN, Ploski RP, Sessler DI, Ezri T. Oxygen Reserve Index: a novel noninvasive measure of oxygen reserve – a pilot study. Anesthesiology 2016; 124: 779-784.
61.
Cheng HW, Yeh CY, Chang MY, Ting CK, Chang PL. How early warning with the Oxygen Reserve Index (ORi™) can improve the detection of desaturation during induction of general anesthesia? J Clin Monit Comput 2022; 36: 1379-1385.
62.
Yoshida K, Isosu T, Noji Y, Hasegawa M, Iseki Y, Oishi R, Imaizumi T, Sanbe N, Obara S, Murakawa M. Usefulness of oxygen reserve index (ORi™), a new parameter of oxygenation reserve potential, for rapid sequence induction of general anesthesia. J Clin Monit Comput 2018; 32: 687-691.
63.
Hille H, Le Thuaut A, Canet E, Lemarie J, Crosby L, Ottavy G, Garret C, Martin M, Seguin A, Lamouche-Wilquin P, Morin J, Zambon O, Miaihle AF, Reignier J, Lascarrou JB. Oxygen reserve index for non-invasive early hypoxemia detection during endotracheal intubation in intensive care: the prospective observational NESOI study. Ann Intensive Care 2021; 11: 112-119.
64.
Koishi W, Kumagai M, Ogawa S, Hongo S, Suzuki K. Monitoring the Oxygen Reserve Index can contribute to the early detection of deterioration in blood oxygenation during one-lung ventilation. Minerva Anestesiol 2018; 84: 1063-1069.
65.
Sagiroglu G, Baysal A, Karamustafaoglu YA. The use of oxygen reserve index in one-lung ventilation and its impact on peripheral oxygen saturation, perfusion index and, pleth variability index. BMC Anesthesiol 2021; 21: 319-329.
66.
Alday E, Nieves JM, Planas A. Oxygen reserve index predicts hypoxemia during one-lung ventilation: an observational diagnostic study. J Cardiothorac Vasc Anesth 2020; 34: 417-422.
67.
Saraçoğlu A, Yamansavci Şirzai E, Yildizeli B, Yüksel M, Aykaç ZZ. Oxygen reserve index guided oxygen titration in one lung ventilation with low fresh gas flow. Turk J Med Sci 2021; 51: 2413-2419.
68.
Yang M, Kim JA, Ahn HJ, Choi YS, Park M, Jeong H, Kim K, Lee NY. Continuous titration of inspired oxygen using Oxygen Reserve Index to decrease oxygen exposure during one-lung ventilation: a randomized controlled trial. Anesth Analg 2022; 135: 91-99.
69.
Lasocki S, Brochant A, Leger M, Gaillard T, Lemarié P, Gergaud S, Dupré P. ORI monitoring allows a reduction of time with hyperoxia in critically ill patients: the randomized control ORI2 study. Intensive Care Med 2019; 45: 1661-1662.
70.
Isosu T, Yoshida K, Oishi R, Imaizumi T, Iseki Y, Sanbe N, Ikegami Y, Obara S, Kurosawa S, Murakawa M. Effects of indigo carmine intravenous injection on oxygen reserve index (ORi™) measurement. J Clin Monit Comput 2018; 32: 693-697.
| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
