Korean Journal of Anesthesiology

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Case Report

DOI: https://doi.org/10.4097/kja.23568
Use of oxygen reserve index during bronchoscopic balloon dilation for subglottic stenosis in a patient with left ventricular assist device implantation -a case report-
Jimin Lee1, Minwoo Chung1, Eui-Suk Sung3, Jung-Pil Yoon1,2, Yeong Min Yoo1,2, Jaesang Bae1, Hee Young Kim1,2 
1Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
2Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea
3Department of Otolaryngology-Head and Neck Surgery, Pusan National University Yangsan Hospital, School of Medicine, Pusan National University and Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea
Corresponding author: Hee Young Kim ,Tel: +82-55-360-2129, Fax: +82-55-360-2149, Email: anekhy@pusan.ac.kr
Received: July 20, 2023; Revised: September 26, 2023   Accepted: October 6, 2023.
Abstract
Background
Monitoring the oxygenation status is crucial during general anesthesia to ensure patient safety. Although noninvasive pulse oximetry is commonly used to monitor percutaneous oxygen saturation (SpO2), it may not accurately reflect changes in oxygen partial pressure when the latter is excessively high or low. The oxygen reserve index (ORi) provides real-time information about the oxygen reserve status.
Case
We present a case of successful management of subglottic stenosis using balloon bronchoscopy in an infant with a left ventricular assist device (LVAD) implantation under ORi monitoring to predict hypoxemia during the surgical procedure.
Conclusions
Utilizing ORi monitoring during anesthesia for procedures involving apnea in critically ill infants can help predict impending desaturation before a drop in SpO2 occurs, allowing anesthesiologists to effectively anticipate and manage the apnea period. Continuous ORi monitoring offers valuable insights during surgical procedures, especially in infants with compromised respiratory and cardiovascular functions.

Keywords :Acquired subglottic stenosis; Bronchoscopic surgical procedure; Bronchoscopy; Dilation; Hypoxia; Oxygen reserve index

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