The Value of ROX Index in Predicting the Outcome of High Flow Nasal Cannula: A Systematic Review and Meta-analysis

Junhai, Zhen; Jing, Yan; Cao, Bangwei; Li, Li

doi:10.21203/rs.3.rs-639947/v2

Cited by 4 publications

(3 citation statements)

References 12 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, relevant studies suggested that ROX index can be used as a new potential marker to identify patients at high risk of HFNC failure. But its prediction effect is not good, and further research is needed to determine the best cut-off value of ROX index and to promote the acquisition time of ROX index [15].…”

Section: Discussionmentioning

confidence: 99%

Relationship between different levels of ROX index and the prognosis of patients receiving high-flow nasal oxygen therapy in ICU

Chong

2023

Preprint

View full text Add to dashboard Cite

Objective: This study aimed investigate the relationship between different levels of ROX index and the prognosis of patients with nasal high-flow oxygen therapy in intensive care unit (ICU). Methods: In this retrospective study, we collected patients receiving high-flow nasal oxygen therapy enrolled in the intensive care unit of our hospital between 2017 and 2022 . The ROX index was calculated according to the physiological indicators of the patients on the first day of admission to the ICU, and they were divided into three subgroups: Q1 (ROX index<3.85), Q2 (ROX index 3.85-4.88) and Q3 (ROX index>4.88). Baseline clinical characteristics and clinical outcomes were compared among the three groups. The Kaplan Meier curves were drawn to compare the 28-day and 60-day survival rates of patients in the three groups, and the prognosis of patients receiving nasal high-flow oxygen therapy in the intensive care unit was further explored by subgroup analysis. COX regression analysis was used to verify the association between the three groups and these indicators. Results: A total of 517 patients with HFNC were enrolled, including 231 patients in Q1 group, 137 patients in Q2 group and 149 patients in Q3 group. Compared with the other two groups, the Q3 group had lower body temperature, heart rate, APACHE II score,serum anion gap, procalcitonin and neutrophil ratio at the beginning of admission. The number of patients with acute respiratory failure and MODS was less than the other two groups. The number of patients using noninvasive mechanical ventilation was also less than that in the other two groups. In addition, patients in Q3 group had a lower rate of death at both 28 and 60 days than those in the Q1 and Q2 groups, and survivors used noninvasive mechanical ventilation less frequently. Subgroup analysis also showed that the lower the ROX index, the higher the mortality of HFNC patients at the subgroup level. Conclusion: The ROX index at the beginning of intensive care unit admission can predict the prognosis of patients with high-flow nasal cannulas. The higher the ROX index level, the better the prognosis of patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Relationship between different levels of ROX index and the prognosis of patients receiving high-flow nasal oxygen therapy in ICU

Chong

2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Several clinical factors such as the severity of illness, demographic factors, and others have been correlated with intubation delays. Even outside the intensive care unit (ICU), the HFNC is used to treat acute hypoxemic respiratory failure (AHRF), and the ROX index may be used to predict HFNC failure (Vega et al, 2022;Junhai et al, 2021;Suliman et al, 2021;Nguyen et al, 2021). The fundamental purpose of this research is to assess the ROX index using a high-flow nasal cannula as a potential predictor of delaying intubation.…”

Section: Background and Literature Reviewmentioning

confidence: 99%

impact of calculating ROX index in delaying intubation with COVID-19 patients at King Abdullah medical city

Alessa

Allehyani

Bsooki

et al. 2022

ijhs

View full text Add to dashboard Cite

Background: HFNC is a respiratory mask that covers the nose like an oxygen mask, with the addition of nasal prongs to deliver extra oxygen. At 12 hours, a ROX score above or equal to 4.88 predicts a decreased probability of progressing to mechanical ventilation. Objective: The aim of this study was to evaluate using a high-flow nasal cannula as a potential predictor of delaying intubation. In doing this, the study also sought to verify whether the ROX index accurately predicts HFNC failure for COVID-19 patients treated in the intensive care unit (ICU). Method: Using retrospective observational analysis of prospectively collected data and the study population of patients in the ICUs at KAMC, the study collects and analyzes data using SPSS. Results: P values that are < 0.05 show that the mean differences are statistically significant, and this is seen on days 1-1, day 1-2, day2-1, day 2-2, day 3-1, day 3-2, day 4-2, day 10-1, and day 10-2. This suggests that ROX index can be used in intubation prediction with COVID-19 patients who have respiratory failure type I that received HFNC therapy.

show abstract

“…5 Studies on predictors of HFNC therapy in pediatric population still shows inconsistent results. 9 This study aims to nd the reliability of the ROX index and modi ed P-ROX index as predictors of HFNC therapy failure in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Respiratory Rate Oxygenation (ROX) Index as Predictor of High Flow Nasal Cannula in Pediatric Patients in Pediatric Intensive Care Unit dr Cipto Mangunkusumo Hospital

Yuniar,

Pudjiadi,

Dewi

et al. 2024

Preprint

View full text Add to dashboard Cite

Background High-flow nasal cannula (HFNC) is often used in pediatric populations with respiratory distress. In adults, the respiratory-rate oxygenation (ROX) index is used as a predictor of HFNC therapy; however, children have age-associated differences in respiratory rate, thus may not be applicable to children. This study aims to find the reliability of ROX index and modified P-ROX index as predictors of HFNC therapy failure in pediatric patients. Methods Subjects in this analytical cross-sectional study were taken from January 2023 until November 2023 in Cipto Mangunkusumo Hospital. Inclusion criteria are children aged 1 month to 18 years with respiratory distress and got HFNC therapy. Receiver operating characteristics (ROC) analysis was used to find mP-ROX index cutoff value as a predictor of HFNC failure. The area under curve (AUC) score of mP-ROX index was assessed at different time point. Results A total of 102 patients, with 70% of the population with pneumonia, were included in this study. There are significant differences in the ROX index between the successful and failed HFNC group therapy (p < 0.05). This study suggests that mP-ROX index is not useful as predictor of HFNC therapy in pediatrics. While ROX index < 5.52 at 60 minutes and < 5.68 at 90 minutes after HFNC initiation have a sensitivity of 90% and specificity of 71%, sensitivity of 78% and specificity of 76%, respectively. Conclusion mP-ROX index is not useful as a predictor of HFNC therapy in pediatrics. Meanwhile, ROX index at 60 minutes and 90 minutes after initiation of HFNC is useful as a predictor of HFNC failure.

show abstract

The Value of ROX Index in Predicting the Outcome of High Flow Nasal Cannula: A Systematic Review and Meta-analysis

Cited by 4 publications

References 12 publications

Relationship between different levels of ROX index and the prognosis of patients receiving high-flow nasal oxygen therapy in ICU

Relationship between different levels of ROX index and the prognosis of patients receiving high-flow nasal oxygen therapy in ICU

impact of calculating ROX index in delaying intubation with COVID-19 patients at King Abdullah medical city

Respiratory Rate Oxygenation (ROX) Index as Predictor of High Flow Nasal Cannula in Pediatric Patients in Pediatric Intensive Care Unit dr Cipto Mangunkusumo Hospital

Contact Info

Product

Resources

About