ERS Respiratory Channel

CDN Connection Issue

It appears that your current network does not allow connection to the CDN (Content Delivery Network) required for this service to function properly.

To resolve this issue, please try the following actions :

• Contact your network administrator : Inform them of this restriction so they can adjust the network settings accordingly.

• Use another network : Try connecting from a different network, such as another Wi-Fi network or a mobile connection.

We apologize for the inconvenience and thank you for your understanding.

Abstract

Introduction: High flow oxygen (HFO) can improve oxygenation and is widely used in post-extubated patients. However, no standard parameter is available to predict HFO outcomes during post-extubation. Ratio of oxygen saturation (ROX) index can effectively predict HFO outcomes in patients with acute hypoxemic respiratory failure in pre-intubated, but not post-extubated period.

Objectives: To investigate whether ROX index predicts the outcomes of HFO in post-extubated patients.

Methods: A retrospective cohort study was performed in ?18-year-old patients with acute respiratory failure receiving post-extubated HFO between 2018 and 2020. Primary outcome was successful extubation. Secondary outcomes were 28-day and hospital mortality, and hospital length of stay (LOS). Baseline characteristics, indication for intubation, respiratory and hemodynamic data 6 hours before, then 2-6, 6-12 and 12-24 hours after HFO use were collected.

Results: Of 236 patients, 196 (83%) succeeded and 40 (17%) failed extubation after HFO use. At 6-12 hours of HFO use, mean±SD of ROX indices (breaths/min)^-1 for successful and failed groups were 12.66±1.89 and 6.71±1.44, and ROX index ?9.4 was strongly associated with successful extubation (AUROC=0.99, 95%CI=0.98-1.00). ROX index ?11.1 at 2-6 hours was associated with higher 28-day and hospital mortality (AUROC=0.65, 95%CI=0.55-0.75 and AUROC=0.73, 95%CI=0.65-0.81), and ROX index at 2-6 hours was associated with shorter hospital LOS (coefficient of median=-1.33, 95%CI=-2.29 to -0.37).

Conclusions: ROX index could predict HFO outcomes in post-extubated patients, with ROX index ?9.4 (breaths/min)^-1 at 6-12 hours of HFO use associated with successful extubation.

Abstract

#{title}