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paediatrics critical-care respiratory

Oxygenation Index (OI)

Calculates the Oxygenation Index to quantify the severity of hypoxic respiratory failure in mechanically ventilated paediatric patients. Used to guide ECMO candidacy and PARDS severity classification.

Score interpretation

No or Minimal Hypoxic Failure

→ OI <4: Adequate oxygenation. No significant hypoxic respiratory failure.

Mild PARDS

→ OI 4–7.9: Mild Paediatric ARDS (PARDS). Optimise ventilation strategy; lung-protective settings.

Moderate PARDS

→ OI 8–15.9: Moderate PARDS. Lung-protective ventilation; PEEP optimisation; consider prone positioning; PICU level care.

Severe PARDS

→ OI 16–25: Severe PARDS. High risk of mortality. Escalate to PICU; consider prone positioning, inhaled nitric oxide, and ECMO consultation.

ECMO Threshold

→ OI >25: Meets threshold for ECMO consideration per PALICC guidelines. Urgent ECMO team consultation; transfer to ECMO centre if not available.

Interpretation bands for the Oxygenation Index. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.