ROX 指数可预测因 SARS-CoV-2 导致的急性呼吸衰竭行高流量鼻导管治疗的成功率。
ROX index as predictor of high flow nasal cannula therapy success in acute respiratory failure due to SARS-CoV-2.
机构信息
Respiratory Medicine Department, Hospital Clínico Universitario, Valencia, Spain; Institue of Health Research INCLIVA, Valencia, Spain.
Respiratory Medicine Department, Hospital Clínico Universitario, Valencia, Spain; Institue of Health Research INCLIVA, Valencia, Spain.
出版信息
Respir Med. 2021 Nov-Dec;189:106638. doi: 10.1016/j.rmed.2021.106638. Epub 2021 Oct 6.
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.
背景
高流量鼻导管（HFNC）治疗在急性呼吸衰竭（ARF）患者中是一种有用的治疗方法。ROX 指数（脉搏血氧饱和度/吸入氧分数与呼吸频率的比值）已被评估用于预测肺炎患者 HFNC 的成功率。
目的
本研究旨在确定 ROX 指数是否可预测因 SARS-CoV-2 肺炎导致 ARF 的患者接受 HFNC 治疗的成功率。
方法
进行了一项观察性、前瞻性研究，纳入了符合 HFNC 治疗启动标准的因 SARS-CoV-2 肺炎导致 ARF 的患者。收集了人口统计学、影像学、实验室和临床病程数据。在开始 HFNC 后 1 小时、6 小时、12 小时和 24 小时计算 ROX 指数。
结果
共纳入 85 例患者（年龄 64.51±11.78 岁；男性 69.4%）。HFNC 失败 47 例（55.3%），其中 45 例（97.8%）最初采用无创通气（NIV）治疗。24 小时 ROX 指数是 HFNC 成功的最佳预测指标（AUC 0.826，95%CI 0.593-1.00，p=0.015），截断值为 5.35（S 0.91，Sp 0.79，PPV 0.92，NPP 0.79）。多变量逻辑回归分析显示，24 小时 ROX 指数是 HFNC 成功的最佳预测指标。
结论
24 小时 ROX 指数，截断值为 5.35，可预测 SARS-CoV-2 引起的 ARF 患者 HFNC 的成功率。
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