New Study Investigates the Ability of Masimo Ori™ to Provide Early Warning of Hypoxemia During Endotracheal Intubation in Icu Patients
September 06, 2021 at 02:00 am EDT
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Masimo announced the findings of a prospective, blinded observational study published in Annals of Intensive Care in which Dr. Jean-Baptiste Lascarrou and colleagues at the Centre Hospitalier Universitaire in Nantes, France evaluated the ability of Masimo ORi™ to predict mild hypoxemia during endotracheal intubation (ETI) in ICU patients. They concluded that the time between decrease in ORi and subsequent decrease in oxygen saturation (SpO2) “may allow preventive action,” and that a higher ORi value during preoxygenation was “independently protective against hypoxemia. ORi, available outside the U.S., is a noninvasive and continuous trending index that extends oxygen monitoring on patients on supplemental oxygen. Enabled by the multi-wavelength rainbow® Pulse CO-Oximetry platform, ORi is provided alongside oxygen saturation (SpO2) measured by clinically proven Masimo SET® pulse oximetry. Noting the importance of optimizing preoxygenation in patients needing ETI, the researchers sought to evaluate whether ORi could provide early warning of impending hypoxemia during the procedure, because ORi “supplies information beyond the range explored by SpO2.” Of the 51 patients who met the inclusion criteria, ORi (alongside SpO2) was monitored using Masimo Radical-7® Pulse. CO-Oximeters® and rainbow® fingertip sensors when preoxygenation began. Values were recorded every two seconds, and attending clinicians were not aware of these values. The primary endpoint measured was the time between ORi decreasing below 0.4 and the onset of mild hypoxemia (defined as SpO2 < 97%). Secondarily, the investigators evaluated whether a decline in ORi during preoxygenation predicted the occurrence of mild hypoxemia during ETI. Analyzing areas under the ROC curve, the researchers found that ORi during preoxygenation predicted SpO2 < 97% during intubation (0.73; 95% confidence interval of 0.58 – 0.88). By contrast, SpO2 at the end of preoxygenation was “poorly predictive” (0.54; 95% CI 0.40 – 0.67). Using univariate analysis, they found that a higher ORi value during preoxygenation was associated with a less frequent occurrence of SpO2 < 97% (odds ratio of 0.09; 95% CI 0.01 – 0.69, p = 0.0199) and that “the highest ORi value during preoxygenation remained significantly associated with a lower risk of SpO2 < 97% during ETI, after adjustment for ETI duration and BMI (odds ratio of 0.76; 95% CI 0.61 – 0.95, p = 0.0141).” The researchers concluded, “The median time between the ORi decrease below 0.4 and the SpO2 decrease below 97% during the apneic period was 81 seconds [34–146]. A higher ORi during preoxygenation was independently associated with a lower risk of mild hypoxemia (SpO2 < 97%).
Masimo Corporation is a global technology company that develops and produces a range of monitoring technologies, including measurements, sensors, patient monitors, and automation and connectivity solutions. The Company's segments include Healthcare and Non-healthcare. Its Healthcare segment develops, manufactures and markets a variety of noninvasive patient monitoring technologies, hospital automation and connectivity solutions, remote monitoring devices and consumer health products. The Company's measurement technologies include Measure-through Motion and Low Perfusion pulse oximetry and advanced rainbow Pulse CO-Oximetry parameters. The Company's Non-healthcare business develops, manufactures, markets, sells home sound integration technologies and accessories, along with licensing complete high performance in-vehicle audio systems under consumer brands, such as Bowers & Wilkins, Denon, Marantz, HEOS, Classe, Polk Audio, Boston Acoustics, and Definitive Technology.