Neonatology
. 2025 Dec 22:1-17.
doi: 10.1159/000550139. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/41428592/
Oxygenation Index and Oxygen Saturation Index in Congenital Diaphragmatic Hernia: Do Management Guidelines Make a Difference?
Tanner S Ellsworth, Ryan J Carpenter, Christian C Yost, Bradley A Yoder, Michelle J Yang
- PMID: 41428592
- DOI: 10.1159/000550139
Free article
Abstract
Objectives: To correlate oxygenation index (OI) and oxygen saturation index (OSI) in congenital diaphragmatic hernia (CDH) and determine guideline changes impact from two different epochs.
Study design: Retrospective analysis of 390 CDH neonates managed at University of Utah/Primary Children’s Hospitals from 2003-2024. We performed regression analysis for paired OI and OSI values over the first week of life (2604 pairs), comparing pre- (2003-2015) and post- (2016-2024) epoch effects of a 2016 CDH guideline. We analyzed predictive abilities for OI and OSI within and between epochs for extracorporeal membrane oxygenation (ECMO) and/or death.
Results: OI and OSI showed higher correlation in the post- (R2 = 0.755) vs pre-epoch (R2 = 0.650). Between epochs analysis demonstrated lower inspired oxygen, mean airway pressure, arterial oxygen pressure, OI, and OSI in the post epoch. Extracorporeal membrane oxygenation (ECMO) use was lower in post epoch (9.8% vs 33%), but pre-ECMO OI and OSI were similar between epochs. Classification of severe lung dysfunction by OI > 25 or OSI > 12 showed similar abilities to predict ECMO and/or death.
Conclusions: OI and OSI were highly correlated in CDH but affected by variation in CDH management. OSI classified severity of cardiopulmonary dysfunction as effectively as OI.
The Author(s). Published by S. Karger AG, Basel.
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