Can the oxygen saturation index predict severe bronchopulmonary dysplasia?

Introduction Even with improvements in perinatal care, bronchopulmonary dysplasia (BPD) continues to be a major challenge, especially in smaller and more premature infants. Early detection of severe BPD can improve treatment outcomes. This study aims to evaluate the correlation between the oxygen saturation index (OSI) and severe BPD/death in preterm infants, with a focus on OSI's predictive value. Methods In this retrospective observational study, infants with a gestational age of less than 30 weeks who required either invasive or non-invasive mechanical ventilation were included. Ventilator settings and OSI values were collected on days 3, 7, 14, 21, and 28 of life. The correlations between postnatal OSIs and outcomes such as death or severe BPD were analysed using multivariate logistic regression. Results Out of the 210 eligible infants, 61 (29%) either died or were diagnosed with severe BPD. In our study, OSI values were significantly higher in preterm infants with severe BPD/death compared to those without severe BPD on postnatal days 14, 21, and 28, and mean OSI values were 5.6, 4.4, and 3.5 respectively. The OSI values with the highest sensitivity and specificity were also found on postnatal days 14, 21, and 28 with cut-off points of 5.4, 4.9, and 2.4 respectively Conclusions This study showed that the sensitivity and specificity of OSI in predicting severe BPD/death were highest on postnatal days 14, 21, and 28. We demonstrated that calculating the OSI, a non-invasive clinical tool, can predict severe BPD/death in infants born before 30 weeks as early as the 14th day of life.