tetano
Editor, Senior Moderator
BMC Pulm Med
. 2023 Aug 10;23(1):294.
doi: 10.1186/s12890-023-02598-y. Reliability of the respiratory rate and oxygenation index for successful high-flow nasal cannula support in coronavirus disease pneumonia: a retrospective cohort study
Ryosuke Hirabayashi[SUP] 1 [/SUP], Kazuma Nagata[SUP] 2 [/SUP], Yuki Sato[SUP] 2 [/SUP], Atsushi Nakagawa[SUP] 2 [/SUP], Ryo Tachikawa[SUP] 2 [/SUP], Hirokazu Kuroda[SUP] 3 [/SUP], Ryutaro Seo[SUP] 4 [/SUP], Takeshi Morimoto[SUP] 5 6 [/SUP], Keisuke Tomii[SUP] 2 [/SUP]
Affiliations
Background: High-flow nasal cannula (HFNC) therapy is an important non-invasive respiratory support in acute respiratory failure, including coronavirus disease (COVID-19) pneumonia. Although the respiratory rate and oxygenation (ROX) index is a simple and useful predictor for HFNC failure and mortality, there is limited evidence for its use in patients with COVID-19 pneumonia. We aimed to evaluate the ROX index as a predictor for HFNC failure in patients with COVID-19 pneumonia. We also evaluated the ROX index as a predictor for 28-day mortality.
Methods: In this single-center, retrospective, cohort study, 248 patients older than 18 years of age with COVID-19 pneumonia received HFNC therapy for acute respiratory failure. The ROX index was evaluated within 4 h from the start of HFNC therapy. Past medical history, laboratory data, and the ROX index were evaluated as predictors for HFNC failure and 28-day mortality.
Results: The ROX index < 4.88 showed a significantly high risk ratio for HFNC failure (2.13 [95% confidence interval [CI]: 1.47 - 3.08], p < 0.001). The ROX index < 4.88 was significantly associated with 28-day mortality (p = 0.049) in patients with COVID-19 pneumonia receiving HFNC therapy. Age, chronic hypertension, high lactate dehydrogenase level, and low ROX index showed significantly high risk ratio for HFNC failure. C-reactive protein level and low ROX index were predictors of 28-day morality.
Conclusion: The ROX index is a useful predictor for HFNC success and 28-day mortality in patients with COVID-19 pneumonia receiving HFNC therapy.
Trial registration: An independent ethics committee approved the study (Research Ethics Review Committee of Kobe City Medical Center General Hospital [number: zn220303; date: February 21, 2022]), which was performed in accordance with the Declaration of Helsinki, Guidelines for Good Clinical Practice.
Keywords: COVID-19; High-flow nasal cannula; Pneumonia; ROX index; Respiratory failure; S/F ratio.
. 2023 Aug 10;23(1):294.
doi: 10.1186/s12890-023-02598-y. Reliability of the respiratory rate and oxygenation index for successful high-flow nasal cannula support in coronavirus disease pneumonia: a retrospective cohort study
Ryosuke Hirabayashi[SUP] 1 [/SUP], Kazuma Nagata[SUP] 2 [/SUP], Yuki Sato[SUP] 2 [/SUP], Atsushi Nakagawa[SUP] 2 [/SUP], Ryo Tachikawa[SUP] 2 [/SUP], Hirokazu Kuroda[SUP] 3 [/SUP], Ryutaro Seo[SUP] 4 [/SUP], Takeshi Morimoto[SUP] 5 6 [/SUP], Keisuke Tomii[SUP] 2 [/SUP]
Affiliations
- PMID: 37559018
- DOI: 10.1186/s12890-023-02598-y
Background: High-flow nasal cannula (HFNC) therapy is an important non-invasive respiratory support in acute respiratory failure, including coronavirus disease (COVID-19) pneumonia. Although the respiratory rate and oxygenation (ROX) index is a simple and useful predictor for HFNC failure and mortality, there is limited evidence for its use in patients with COVID-19 pneumonia. We aimed to evaluate the ROX index as a predictor for HFNC failure in patients with COVID-19 pneumonia. We also evaluated the ROX index as a predictor for 28-day mortality.
Methods: In this single-center, retrospective, cohort study, 248 patients older than 18 years of age with COVID-19 pneumonia received HFNC therapy for acute respiratory failure. The ROX index was evaluated within 4 h from the start of HFNC therapy. Past medical history, laboratory data, and the ROX index were evaluated as predictors for HFNC failure and 28-day mortality.
Results: The ROX index < 4.88 showed a significantly high risk ratio for HFNC failure (2.13 [95% confidence interval [CI]: 1.47 - 3.08], p < 0.001). The ROX index < 4.88 was significantly associated with 28-day mortality (p = 0.049) in patients with COVID-19 pneumonia receiving HFNC therapy. Age, chronic hypertension, high lactate dehydrogenase level, and low ROX index showed significantly high risk ratio for HFNC failure. C-reactive protein level and low ROX index were predictors of 28-day morality.
Conclusion: The ROX index is a useful predictor for HFNC success and 28-day mortality in patients with COVID-19 pneumonia receiving HFNC therapy.
Trial registration: An independent ethics committee approved the study (Research Ethics Review Committee of Kobe City Medical Center General Hospital [number: zn220303; date: February 21, 2022]), which was performed in accordance with the Declaration of Helsinki, Guidelines for Good Clinical Practice.
Keywords: COVID-19; High-flow nasal cannula; Pneumonia; ROX index; Respiratory failure; S/F ratio.