Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China.
BMC Pulm Med. 2022 Jun 13;22(1):227. doi: 10.1186/s12890-022-02017-8.
This study was designed to explore the early predictive value of the respiratory rate oxygenation (ROX) index modified by PaO (mROX) in high-flow nasal cannula (HFNC) therapy in patients with acute hypoxemia respiratory failure (AHRF).
Seventy-five patients with AHRF treated with HFNC were retrospectively reviewed. Respiratory parameters at baseline and 2 h after HFNC initiation were analyzed. The predictive value of the ROX (ratio of pulse oximetry/FIO to respiratory rate) and mROX (ratio of arterial oxygen /FIO to respiratory rate) indices with two variations by adding heart rate to each index (ROX-HR and mROX-HR) was evaluated.
HFNC therapy failed in 24 patients, who had significantly higher intensive care unit (ICU) mortality and longer ICU stay. Both the ROX and mROX indices at 2 h after HFNC initiation can predict the risk of intubation after HFNC. Two hours after HFNC initiation, the mROX index had a higher area under the receiver operating characteristic curve (AUROC) for predicting HFNC success than the ROX index. Besides, baseline mROX index of greater than 7.1 showed a specificity of 100% for HFNC success.
The mROX index may be a suitable predictor of HFNC therapy outcomes at the early phase in patients with AHRF.
本研究旨在探讨经动脉血氧分压（PaO ）校正的呼吸率氧合（ROX）指数（mROX）在高流量鼻导管（HFNC）治疗急性低氧性呼吸衰竭（AHRF）患者中的早期预测价值。
回顾性分析 75 例接受 HFNC 治疗的 AHRF 患者。分析 HFNC 起始后 2 小时的呼吸参数。评估 ROX（脉搏血氧饱和度/FIO 与呼吸率的比值）和 mROX（动脉氧/FIO 与呼吸率的比值）指数及其两种变体（每个指数均添加心率）的预测值（ROX-HR 和 mROX-HR）。
HFNC 治疗失败 24 例，这组患者 ICU 死亡率和 ICU 住院时间明显更长。HFNC 起始后 2 小时的 ROX 和 mROX 指数均能预测 HFNC 后插管的风险。HFNC 起始后 2 小时，mROX 指数预测 HFNC 成功的 AUC 高于 ROX 指数。此外，mROX 指数的基线值大于 7.1 可特异性预测 HFNC 成功。
mROX 指数可能是 AHRF 患者 HFNC 治疗早期结局的合适预测指标。
