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. 2025 Jan 6:11:1495543.
doi: 10.3389/fvets.2024.1495543. eCollection 2024.

Use of the oxygen reserve index/FiO2 as a non-invasive index to estimate venous admixture in anesthetized dogs

Luca Bellini  1 , Jill K Maney  2 , Francesca Zanusso  1 , Brighton T Dzikiti  2
Affiliations

Use of the oxygen reserve index/FiO2 as a non-invasive index to estimate venous admixture in anesthetized dogs

Luca Bellini et al. Front Vet Sci. .

Abstract

The oxygen reserve index (ORi) is a novel, non-invasive parameter that estimates arterial oxygen partial pressure (PaO2) during hyperoxia when the fraction of inspired oxygen (FiO2) is elevated. This study aimed to assess the utility of the ORi/FiO2 ratio as an index for quantifying F-shunt, serving as an estimate of venous admixture. Anesthetic records were reviewed from 44 dogs undergoing general anesthesia and requiring arterial catheterization. ORi was measured via a CO-oximeter using a probe on the tongue. Paired measurements of PaO2, obtained by blood gas analysis, and ORi were taken at various FiO2 levels to achieve an ORi between 0 and 1. Venous admixture was quantified by F-shunt. Spearman's correlation coefficient assessed the relationship between ORi/FiO2 and F-shunt. Youden's index identified the optimal cut-off point to predict a physiological F-shunt (≤ 10%). A total of 77 paired observations were collected, revealing a moderate negative correlation between F-shunt and ORi/FiO2 (rho = -0.59, p < 0.001). An ORi/FiO2 cut-off of 1.2 demonstrated 80% sensitivity for identifying dogs with an F-shunt ≤10%, with a ROC curve area above 80%. However, the index was less effective at distinguishing dogs with higher shunt fractions. The ORi/FiO2 index identifies dogs with low F-shunt during anesthesia with strong sensitivity and predictive accuracy, potentially ruling out the occurrence of ventilation-perfusion inequality. However, it cannot replace blood gas analysis for quantifying venous admixture.

Keywords: F-shunt; anesthesia; blood gas analysis; dogs; oxygen reserve index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Scatterplot showing the PaO2/FiO2 ratio. (B) Scatterplot showing the ORi/FiO2 ratio. A regression line has been added, with the grey area representing the 95% confidence intervals. ORi, oxygen reserve index; PaO2, partial pressure of oxygen; FiO2, fraction inspired of oxygen; R, Spearman’s correlation coefficient.
See this image and copyright information in PMC

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