Evaluating the use of the respiratory-rate oxygenation index as a predictor of high-flow nasal cannula oxygen failure in COVID-19

Scott Weerasuriya; Savvas Vlachos; Ahmed Bobo; Namitha Birur Jayaprabhu; Lauren Matthews; Adam R Blackstock; Victoria Metaxa

doi:10.4266/acc.2022.01081

추천

검색

자료유형: 학술저널

저자정보: Scott Weerasuriya (Department of Critical Care Medicine King’s College Hospital NHS Foundation Trust London UK) Savvas Vlachos (Department of Critical Care Medicine King’s College Hospital NHS Foundation Trust London UK) Ahmed Bobo (Department of Critical Care Medicine King’s College Hospital NHS Foundation Trust London UK) Namitha Birur Jayaprabhu (Department of Critical Care Medicine King’s College Hospital NHS Foundation Trust London UK) Lauren Matthews (Department of Critical Care Medicine King’s College Hospital NHS Foundation Trust London UK) Adam R Blackstock (Department of Critical Care Medicine King’s College Hospital NHS Foundation Trust London UK) Victoria Metaxa (Department of Critical Care Medicine King’s College Hospital NHS Foundation Trust London UK)

저널정보: 대한중환자의학회 Acute and Critical Care Acute and Critical Care 제38권 제1호

발행연도: 2023.2

수록면: 31 - 40 (10page)

DOI: 10.4266/acc.2022.01081

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Background It can be challenging for clinicians to predict which patients with respiratory failure secondary to coronavirus disease 2019 (COVID-19) will fail on high-flow nasal cannula (HFNC) oxygen and require escalation of therapy. This study set out to evaluate the association between the respiratory rate-oxygenation index (ROX) and HFNC failure in such patients and to assess whether ROX trajectory correlates with treatment failure. Methods This was a single-centre, retrospective, observational study of patients with COVID-19 requiring HFNC, conducted over a 3-month period. ROX was calculated as "pulse-oximetry oxygen saturation (SpO2) over the fractional inspired oxygen concentration (FiO2)/respiratory rate" for each patient at 2, 4, and 12 hours from starting HFNC. HFNC failure was defined as escalation to continuous positive airway pressure ventilation or invasive mechanical ventilation (IMV). Time-to-event analyses were performed to account for the longitudinal data set and time-dependent variables. Results We included 146 patients. Ninety-three (63.7%) experienced HFNC failure, with 53 (36.3%) requiring IMV. Higher ROX values were associated with a lower subhazard of HFNC failure on time-to-HFNC failure analysis (subhazard ratio, 0.29; 95% confidence interval [CI], 0.18–0.46; P<0.001). This remained true after controlling for informative censoring. Median ROX values changed differentially over time, increasing in the HFNC success group (0.06 per hour; 95% CI, 0.05–0.08; P<0.001) but not in the HFNC failure group (0.004 per hour; 95% CI, –0.05 to 0.08; P=0.890). Conclusions A higher ROX is associated with a lower risk of HFNC failure. Monitoring ROX trajectory over time may help identify patients at risk of treatment failure. This has potential clinical applications; however, future prospective studies are required.

#COVID-19 #critical care #respiratory failure #respiratory infections

참고문헌 (0)

참고문헌 신청

참고문헌이 DBpia에서 서비스 중이라면, [참고문헌 신청]을 통해 등록해보세요

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!