Eriş Esra, Mammadova Ayshan, Kara Ayşe Taşçı, Atasoy Aydın, Solmaz Zeynep Sena, Gürsel Gül
Critical Care Fellowship Program, Gazi University School of Medicine, Ankara.
Department of Pulmonary Critical Care Medicine, Gazi University School of Medicine, Ankara.
Monaldi Arch Chest Dis. 2025 Jul 21;95(2). doi: 10.4081/monaldi.2024.2840. Epub 2024 Jul 23.
This study aimed to investigate the predictive value of the ratio of oxygen saturation (ROX) index calculated during mechanical ventilation (MV) and the weaning period in evaluating readiness to wean and the success of the spontaneous breathing trial (SBT), extubation, and mortality. We also compared the results of the ROX index calculated with partial arterial oxygen pressure (PaO2), arterial oxygen saturation (SaO2%), and probe oxygen saturation (SpO2%). In this retrospective cohort study, the ROX index was calculated by SpO2%, PaO2, and SaO2% separately using the ROX index formula (PaO2 or SaO2 or SpO2 /FiO2)/respiratory rate. ROX was calculated during the first 3 days of MV treatment and the weaning period daily (SBT). Positive end-expiratory pressure and peak inspiratory pressure values were also recorded during these measurements. These ROX values were used to analyze whether they predict weaning readiness, SBT, extubation failure (EF), and mortality. The study included 107 mechanically ventilated patients. Weaning could be tried in 64 (60%) of the 107 patients; 44 (69%) of the 64 patients succeeded, and extubation was performed. 19 (43%) of 44 patients had EF. ROX values calculated with PaO2 during MV and SBT predicted readiness to wean, EF, and mortality better than ROX values calculated with SaO2 and SpO2. ROX values calculated with PaO2 during the third day of MV had the highest sensitivity and specificity for EF (sensitivity: 81%, specificity: 70% for the ROX<11 value). The results of this study suggest that the calculation of the ROX index, not only with SpO2% but also with arterial blood gas PaO2 and SaO2% values, may be helpful in predicting the weaning readiness evaluation, SBT, and extubation success and mortality. Further studies with more patients are necessary to verify and standardize these results.
本研究旨在探讨机械通气（MV）期间及撤机期计算的氧饱和度比值（ROX）指数在评估撤机准备情况、自主呼吸试验（SBT）成功与否、拔管及死亡率方面的预测价值。我们还比较了用部分动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2%）和经皮血氧饱和度（SpO2%）计算的ROX指数结果。在这项回顾性队列研究中，ROX指数通过ROX指数公式（PaO2或SaO2或SpO2 /FiO2）/呼吸频率分别由SpO2%、PaO2和SaO2%计算得出。在MV治疗的前3天及撤机期每日（SBT）计算ROX。在这些测量期间还记录呼气末正压和吸气峰压值。这些ROX值用于分析它们是否能预测撤机准备情况、SBT、拔管失败（EF）和死亡率。该研究纳入了107例机械通气患者。107例患者中有64例（60%）可以尝试撤机；64例患者中有44例（69%）成功，并进行了拔管。44例患者中有19例（43%）发生EF。MV和SBT期间用PaO2计算的ROX值在预测撤机准备情况、EF和死亡率方面比用SaO2和SpO2计算的ROX值更好。MV第3天用PaO2计算的ROX值对EF具有最高的敏感性和特异性（对于ROX<11值，敏感性：81%，特异性：70%）。本研究结果表明，不仅用SpO2%，而且用动脉血气PaO2和SaO2%值计算ROX指数，可能有助于预测撤机准备情况评估、SBT、拔管成功率及死亡率。需要更多患者的进一步研究来验证和规范这些结果。
