High-velocity nasal insufflation success assessment using ROX index in patients with acute respiratory failure

IF 0.2 Q4 RESPIRATORY SYSTEM
H. Shalaby, Hoda S. Mohamed
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引用次数: 0

Abstract

Background High-velocity nasal insufflation (Hi-VNI) in patients with acute respiratory failure (ARF) gives humidified, heated oxygen, with a higher velocity, and gas flow up to 40 l/min, and FiO2 up to 1.0 through more comfortable, relatively small nasal prongs. respiratory rate-oxygenation (ROX) index is an easy bedside test, variable with time, and helps in decision making in the daily follow-up of patients on Hi-VNI. Aim The aim was to validate the accuracy of ROX index in the early detection of patients with ARF who will fail using Hi-VNI and need early intubation without worsening their clinical prognosis. Patients and methods A prospective observational cohort study was performed on 40 patients with ARF who received Hi-VNI treatment. Application of Hi-VNI was done once indicated, and after 2, 6, and 12 h, intensivists calculated ROX indices. Then, follow-up patients was performed for the need for intubation, ICU length of stay, and 28-day mortality. Results Patients treated with Hi-VNI were divided into two groups: the successful group and the unsuccessful group. A total of 20 patients (50%) required intubation after Hi-VNI. Their median ROX indices were 4.25, 4.6, and 4.8 after 2, 6, and 12 h, respectively. The ROX index can predict the risk of intubation in patients with ARF. However, in the successful group, ROX indices were 6.35, 6.29, and 7.05 after 2, 6, and 12 h, respectively. The ROX index was an accurate predictor of success (area under the curve=1.00). Conclusion In patients with ARF treated by Hi-VNI, the ROX index is a bedside test, daily used in ICU, and can early predict patients who will fail using Hi-VNI and need intubation, thus avoiding delayed intubation and worse clinical outcome.
应用ROX指数评价急性呼吸衰竭患者高速鼻灌气成功率
背景:在急性呼吸衰竭(ARF)患者中,高速鼻腔注入(Hi-VNI)通过更舒适、相对较小的鼻尖,以更高的速度给予湿化、加热的氧气,气体流量可达40 l/min, FiO2可达1.0。呼吸速率-氧合(ROX)指数是一个简单的床边测试,随时间变化,有助于Hi-VNI患者日常随访的决策。目的验证ROX指数在早期发现使用Hi-VNI治疗失败、需要早期插管且不影响临床预后的ARF患者中的准确性。患者和方法对40例接受Hi-VNI治疗的ARF患者进行了前瞻性观察队列研究。一旦有指示,应用Hi-VNI,在2、6和12小时后,强化师计算ROX指数。然后,随访患者插管需求、ICU住院时间和28天死亡率。结果Hi-VNI患者分为治疗成功组和治疗不成功组。共有20例患者(50%)在Hi-VNI后需要插管。术后2、6、12 h ROX指数中位数分别为4.25、4.6、4.8。ROX指数可预测ARF患者插管风险。而成功组在治疗2、6、12 h后ROX指数分别为6.35、6.29、7.05。ROX指数是成功的准确预测指标(曲线下面积=1.00)。结论在经Hi-VNI治疗的ARF患者中,ROX指数是一项床边测试,可在ICU日常使用,可早期预测Hi-VNI治疗失败而需要插管的患者,避免延迟插管和不良临床结局。
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来源期刊
自引率
0.00%
发文量
46
审稿时长
22 weeks
期刊介绍: The journal will cover technical and clinical studies related to health, ethical and social issues in field of The Egyptian Journal of Chest Diseases and Tuberculosis aims to publish and inform readers and all chest physicians of the progress in medical research concerning all aspect of chest diseases. Publications include original articles review articles, editorials, case studies and reports which are relevant to chest diseases. The Journal also aims to highlight recent updates in chest medicine. . Articles with clinical interest and implications will be given preference.
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