Prediction value of oxygenation index as predictor for postoperative pulmonary complications in urologic surgery

Mojsova Mijovska, Maja and Gavrilovska-Brzanov, Aleksandra and Jovanovski Srceva, Marija and Brzanov, Nikola and Ehmer Nelepa, Zuzanne (2019) Prediction value of oxygenation index as predictor for postoperative pulmonary complications in urologic surgery. International Journal of Medical and Biomedical Studies, 3 (3). pp. 52-57. ISSN 2589-8698

Text PREDICTION VALUE OF OXYGENATION INDEX AS PREDICTOR FOR POSTOPERATIVE.pdf - Published Version Download (1MB)

Abstract

Introduction: It is believed that pressure/flow (P/F) ratio (arterial oxygen to inspired oxygen fraction)
Does not give the best expression of oxygenation status in mechanically ventilated patients. Therefore,
a new oxygenation index (OI) where the mean airway pressure (MAP) is incorporated (PaO2/FiOxMAP)
Is showed as superior to P/F in expression of the lung oxygenation status. In this article we wanted to
assess the prediction value of OI calculated during urological surgeries as a predictive marker for
Developing postoperative pulmonary complications (PPC).
Material and methods: We evaluated all elective urologic patients operated in general endotracheal
anesthesia, aged 18 to 65 years, without any known history of respiratory disease for the period from
January till December 2017. We calculated the P/F ratio and the OI at three time points: after induction
in general endotracheal anesthesia in the beginning of mechanical ventilation, 1 hour after induction in
Anesthesia, and at the end of the surgery before weaning the mechanical ventilation. The primary
Outcomes were PPC defined by European Society of Anesthesia. The second outcomes were: length of
Hospital stay, admission to intensive care unit (ICU) and mortality.
Results: A total of 240 patients who met the inclusion criteria were included in this evaluation and
finally analyzed. PPC was diagnosed in 25% of patients and respectively 75% were without
Complications. The postoperative hospital stay was longer in PPC group no matter they were operated
laparoscopically or with classic open surgery (PPC laparoscopy 4.9 ± 2.2 vs. non PPC laparoscopy 3.3 ±
1.7, PPC laparotomy 6.8 ± 5.2 vs. non PPC 5.6 ± 2.1 laparotomy). Ten patients were admitted to ICU, 8
from PPC group and 2 from non PPC group. In PPC group patients were admitted to ICU for mean 3.7 ±
2.4 days, and in non PPC group patients were hospitalized in ICU only for 2 days. All evaluated patients
were discharged from the hospital and no mortality was observed in the 30 postoperative days.
In the univariate and multivariate logistic regression analysis neither OI nor P/F were significantly
associated with PPC.
Conclusion: This study does not offer a conclusive answer to the prediction value of OI for PPC. It
would be fruitful to pursue further research about predictive variables for pulmonary complications.
Keywords: oxygenation index, pressure/flow ratio, mean airway pressure, postoperative pulmonary
complications.

Item Type:	Article
Impact Factor Value:	40.03
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Maja Mojsova Mijovska
Date Deposited:	31 Mar 2023 08:44
Last Modified:	31 Mar 2023 08:44
URI:	https://eprints.ugd.edu.mk/id/eprint/31552

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