Performance of the ROX index to predict intubation in immunocompromised patients receiving high-flow nasal cannula for acute respiratory failure

Autor: Lemiale, V, Dumas, G, Demoule, A, Pène, F, Kouatchet, A, Bisbal, M, Nseir, S, Argaud, L, Kontar, L, Klouche, K, Barbier, F, Seguin, A, Louis, G, Constantin, JM, Mayaux, J, Wallet, F, Peigne, V, Girault, C, Oziel, J, Nyunga, M, Terzi, N, Bouadma, L, Lautrette, A, Bige, N, Raphalen, JH, Papazian, L, Bruneel, F, Lebert, C, Benoit, Dominique, Meert, AP, Jaber, S, Mokart, D, Darmon, M, Azoulay, E, de Recherche en Reanimation Respiratoire du patient d’Onco-Hématologie (GRRR-OH, Groupe
Přispěvatelé: Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Picardie Jules Verne (UPJV), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Multivariate analysis
Oxygenation index
high-flow nasal oxygen
medicine.medical_treatment
Acute respiratory failure
Critical Care and Intensive Care Medicine
medicine.disease_cause
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Anesthesiology
Medicine and Health Sciences
medicine
[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]
Intubation
Immunocompromised
acute respiratory failure
business.industry
Research
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Correction
030208 emergency & critical care medicine
lcsh:RC86-88.9
High-flow nasal oxygen
medicine.disease
3. Good health
Pneumonia
immunocompromised
030228 respiratory system
Anesthesia
Economie
business
Nasal cannula
Zdroj: Annals of Intensive Care
Annals of Intensive Care, SpringerOpen, 2021, 11, pp.17. ⟨10.1186/s13613-021-00801-z⟩
ANNALS OF INTENSIVE CARE
Annals of Intensive Care, Vol 11, Iss 1, Pp 1-9 (2021)
Annals of intensive care, 11 (1
ISSN: 2110-5820
Popis: Background: Delayed intubation is associated with high mortality. There is a lack of objective criteria to decide the time of intubation. We assessed a recently described combined oxygenation index (ROX index) to predict intubation in immunocompromised patients. The study is a secondary analysis of randomized trials in immunocompromised patients, including all patients who received high-flow nasal cannula (HFNC). The first objective was to evaluate the accuracy of the ROX index to predict intubation for patients with acute respiratory failure. Results: In the study, 302 patients received HFNC. Acute respiratory failure was mostly related to pneumonia (n = 150, 49.7%). Within 2 (1–3) days, 115 (38.1%) patients were intubated. The ICU mortality rate was 27.4% (n = 83). At 6 h, the ROX index was lower for patients who needed intubation compared with those who did not [4.79 (3.69–7.01) vs. 6.10 (4.48–8.68), p < 0.001]. The accuracy of the ROX index to predict intubation was poor [AUC = 0.623 (0.557–0.689)], with low performance using the threshold previously found (4.88). In multivariate analysis, a higher ROX index was still independently associated with a lower intubation rate (OR = 0.89 [0.82–0.96], p = 0.04). Conclusion: A ROX index greater than 4.88 appears to have a poor ability to predict intubation in immunocompromised patients with acute respiratory failure, although it remains highly associated with the risk of intubation and may be useful to stratify such risk in future studies.
SCOPUS: ar.j
info:eu-repo/semantics/published
Databáze: OpenAIRE
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