ROX index as predictor of high flow nasal cannula therapy success in acute respiratory failure due to SARS-CoV-2 - 08/12/21
, Irene Bocigas a, b, Enric Bures a, b, Heidi Mora a, b, Erik Monclou a, b, Alba Mulet a, b, Antonio Quezada a, b, Pablo Royo a, b, Jaime Signes-Costa a, b
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Abstract |
Background |
High-Flow Nasal Cannula (HFNC) therapy is useful treatment in patients with acute respiratory failure (ARF). The ROX index (ratio of pulse oximetry/fraction of inspired oxygen to respiratory rate) has been evaluated to predict success of HFNC in patients with pneumonia.
Objective |
The aim of this study was to determine whether the ROX Index could predict HFNC therapy success in patients with ARF due to SARS-CoV-2 pneumonia.
Methods |
An observational, prospective study was performed including patients admitted with ARF secondary to SARS-CoV-2 pneumonia who met criteria for HFNC therapy initiation. Demographic, radiological, laboratory and clinical course data were collected. The ROX index was calculated at 1 h, 6 h, 12 h and 24 h after starting HFNC.
Results |
In total 85 patients were included (age, 64.51 + 11.78 years; male, 69.4%). HFNC failed in 47 (55.3%) patients, of whom 45 (97.8%) were initially managed with noninvasive ventilation (NIV). ROX index at 24 h was the best predictor of HFNC success (AUC 0.826, 95%CI 0.593–1.00, p = 0.015) with a cut-off point of 5.35 (S 0.91, Sp 0.79, PPV 0.92, NPP 0.79). In multivariate logistic regression analysis ROX index at 24 h proved the best predictor of HFNC success.
Conclusions |
ROX index at 24 h with a cut-off point of 5.35 predicts HFNC success in patients with SARS-Cov-2-induced ARF.
Le texte complet de cet article est disponible en PDF.Highlights |
• | ROX index is the most accurate predictor for HFNC therapy success in acute respiratory failure due to COVID-19. |
• | 24h ROX index (cut-off point 5.35) predicts HFNC therapy success in patients with SARS-Cov-2- and acute respiratory failure. |
• | HFNC and noninvasive ventilation as rescue therapy avoid endotracheal intubation or death in 59% of patients with COVID-19. |
Keywords : COVID-19, Respiratory failure, High flow nasal cannula, Mechanical ventilation
Plan
Vol 189
Article 106638- novembre 2021 Retour au numéro
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