Journal of perinatology : official journal of the California Perinatal Association
April 10, 2026 · via Europe PMC
Noninvasive oxygenation monitoring in PPHN: validation of the oxygen saturation index and the oxygen saturation to fraction of inspired oxygen ratio against conventional invasive indices.
Li D, Yao M, Shi H, Jia C, Feng L, Ma L, Tang L.
AI summary — for doctors, generated from the abstract only
OSI and S/F ratio reliably substitute for invasive oxygenation indices in PPHN when SpO2 is 80% or higher.
What was studied
Retrospective analysis of 2717 paired blood gas and SpO2 measurements from 377 PPHN infants, 2012-2021.
Key findings
- OSI correlated strongly with OI (r=0.93), and S/F with P/F (r=0.84).
- Agreement was best at SpO2 of 80% or above and declined with severe hypoxemia.
- OSI AUC exceeded 0.96.
Clinical relevance
Noninvasive indices can reduce arterial sampling.
Who should care
Limitations
Single-center retrospective data, with reduced reliability in severe hypoxemia.
Use OSI and S/F for trending when SpO2 is 80% or above, but use arterial gases in severe hypoxemia.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To evaluate the correlation and agreement between the Oxygen Saturation Index (OSI) and Oxygenation Index (OI), and between the SpO2/FiO2 ratio (S/F) and PaO2/FiO2 ratio (P/F) in neonates with persistent pulmonary hypertension (PPHN), and to identify noninvasive thresholds for clinical use.
Study design
This retrospective study analyzed 2717 paired arterial blood gas and SpO2 measurements from 377 PPHN infants treated at a tertiary NICU (2012-2021). Correlation (Spearman), linear mixed-effects models (LMMs), Bland-Altman agreement, and ROC analyses were performed across SpO2 strata.
Results
OSI strongly correlated with OI (r = 0.93), and S/F with P/F (r = 0.84), with best performance at SpO2 ≥80%. Agreement declined under severe hypoxemia. ROC analysis showed excellent discrimination for OSI (AUC > 0.96) and good performance for S/F (AUC up to 0.96).
Conclusion
OSI and S/F are reliable noninvasive surrogates for invasive oxygenation indices when SpO2 ≥ 80% and may help reduce arterial sampling in PPHN monitoring.
DOI
10.1038/s41372-026-02663-4
PMID
41963715
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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