Calculator: Oxygenation index in neonates, children, and adults

Input

FIO₂
Mean airway pressure
PaO₂

Result

Important: Inputs must be complete to perform calculation.


OI

Decimal precision

Severity of hypoxic respiratory failure in neonates

OI <15:	Mild
OI ≥15 and <25:	Moderate
OI ≥25 and <40:	Severe
OI ≥40:	Very severe

Severity of hypoxic respiratory failure in pediatric (beyond neonatal period) and adult patients

OI <8:	Mild
OI ≥8 and <16:	Moderate
OI ≥16 and <40:	Severe
OI ≥40:	Very severe

Notes

The OI is used to assess the severity of hypoxic respiratory failure in neonates, infants, children, and adults. In neonates, these indices are most commonly used in patients with PPHN or CDH. In pediatric and adult patients, the OI is sometimes used to assess the severity of ARDS. Higher OI values correlate with increased risk of mortality.
In pediatric patients, an OI <8 is an indicator that it may be appropriate to perform extubation readiness testing.
In neonatal and pediatric patients, an OI ≥40 is an indicator that it may be appropriate to transfer to an ECMO center.
OI: oxygenation index; PPHN: persistent pulmonary hypertension of the newborn; CDH: congenital diaphragmatic hernia; ARDS: acute respiratory distress syndrome; ECMO: extracorporeal membrane oxygenation.

Equations used

OI = FIO₂ * Mean_airway_pressure / PaO₂

References

Trachsel D, McCrindle BW, Nakagawa S, Bohn D. Oxygenation index predicts outcome in children with acute hypoxemic respiratory failure. Am J Respir Crit Care Med 2005; 172:206.
Spicer A, Lo V, Khemani RG, et al. Oxygenation index independently predicts mortality in pediatric acute lung injury in the era of low tidal volume ventilation. Pediatr Acad Soc Conf 2013; 2912.
Khemani RG, Smith LS, Zimmerman JJ, Erickson S. Pediatric acute respiratory distress syndrome: definition, incidence, and epidemiology: proceedings from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med 2015;16:S23.
Golombek SG, Young JN. Efficacy of inhaled nitric oxide for hypoxic respiratory failure in term and late preterm infants by baseline severity of illness: a pooled analysis of three clinical trials. Clin Ther 2010; 32:939.

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Calculator: Oxygenation index in neonates, children, and adults