比较ROX指数与心率、血流率、PaO2/FiO2比值等改良指标对拔管后高流量鼻插管治疗患者预后的早期预测。

IF 2.8 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

European Journal of Medical Research Pub Date : 2025-03-14 DOI:10.1186/s40001-025-02402-z

Smitesh Gutta, Wei Jun Dan Ong, Shanaz Matthew Sajeed, Belinda Zer Hui Chern, Monika Gulati Kansal, Faheem Ahmed Khan, Amit Kansal

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引用次数: 0

摘要

背景：假设心率、血流率和PaO2/FIO2 （PF）比值与ROX指数相结合，可以更好地预测拔管后高流量鼻插管（HFNC）的使用结果。因此，我们的目的是比较ROX指数和新的修正指数，以预测拔管后HFNC的结果。方法：这项为期6年的单中心回顾性研究纳入了拔管后HFNC的受试者。修正后的指标（ROX-HR、ROX-HR- flow和POX-HR-Flow）包括HFNC流速、心率和用PF代替SF。使用AUROC进行评估，并评估截断值以预测HFNC结果。结果：81例患者拔管后开始HFNC治疗，其中67例（82.7%）成功。hfnc启动后2 h的ROX-HR-Flow预测准确率最高（AUROC 0.854, 95% CI 0.756 ~ 0.952）。HFNC开始后2小时ROX-HR-Flow > 12.25与较低的HFNC失败风险显著相关（敏感性77.6%，特异性85.7%）。结论：与拔管后使用HFNC的受试者的ROX指数相比，我们提出的HFNC启动后2小时的修正指数（ROX- hr - flow）可以更早、更准确地预测HFNC的结果。

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Comparison of ROX index with modified indices incorporating heart rate, flow rate, and PaO₂/FiO₂ ratio for early prediction of outcomes among patients initiated on post-extubation high-flow nasal cannula therapy.

Background: Incorporation of heart rate, flow rate, and PaO₂/FIO₂ (PF) ratio to ROX index has been postulated to better predict high-flow nasal cannula (HFNC) usage outcomes in post-extubation setting. Therefore, we aimed to compare ROX index with new modified indices to predict HFNC outcomes in the post-extubation setting.

Methods: This single-centre 6-year retrospective study included subjects initiated on HFNC post-extubation. The modified indices (ROX-HR, ROX-HR-Flow and POX-HR-Flow) incorporated HFNC flow rate, heart rate and substituted PF ratio for SF ratio. Evaluation was performed using AUROC and cut-offs assessed for prediction of HFNC outcomes.

Results: Eighty-one subjects were initiated on HFNC post-extubation, of whom 67 patients (82.7%) had HFNC success. ROX-HR-Flow at 2 h post-HFNC initiation demonstrated the best prediction accuracy (AUROC 0.854, 95% CI 0.756-0.952). A ROX-HR-Flow > 12.25 at 2 h post-HFNC initiation was significantly associated with a lower risk of HFNC failure (Sensitivity 77.6% and Specificity 85.7%).

Conclusions: Our proposed modified index at 2 h post-HFNC initiation (ROX-HR-Flow), may facilitate early and accurate prediction of HFNC outcomes compared to ROX index among subjects initiated on HFNC in the post-extubation setting.

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来源期刊

European Journal of Medical Research 医学-医学：研究与实验

CiteScore

3.20

自引率

0.00%

发文量

247

审稿时长

>12 weeks

期刊介绍： European Journal of Medical Research publishes translational and clinical research of international interest across all medical disciplines, enabling clinicians and other researchers to learn about developments and innovations within these disciplines and across the boundaries between disciplines. The journal publishes high quality research and reviews and aims to ensure that the results of all well-conducted research are published, regardless of their outcome.