%0 Journal Article %A Claudi, Debby %A Arifin, Hasanul %A Prasetya, Raka Jati %T The role of ROX index in predicting intubation in COVID-19 pneumonia receiving high flow nasal cannula: A systematic review %D 2022 %J Journal of Emergency Medicine, Trauma and Acute Care, %V 2022 %N 2 %@ 1999-7094 %C 8 %R https://doi.org/10.5339/jemtac.2022.8 %K intubation %K ROX index %K pneumonia %K COVID-19 %K high flow nasal cannula %I Hamad bin Khalifa University Press (HBKU Press), %X Introduction: One of the important COVID-19 management considerations was to prevent delayed intubation. There is a lack of objective criteria to decide the time of intubation. Previously, respiratory parameters were the only tools used to determine the success of high flow nasal cannula (HFNC) therapy, but several studies have reported on the role of respiratory rate oxygenation (ROX) index which combined respiratory rate (RR) and oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) in predicting intubation after receiving high flow nasal cannula (HFNC). The primary objective of this study was to evaluate the validity of the ROX index in predicting intubation in COVID-19 pneumonia receiving HFNC. Methods: This study is a systematic review that used online databases (PubMed, Science Direct, Google Scholar, and CENTRAL) in obtaining eligible journals. The sources of data were from published observational studies and preprints. The outcomes of this study were ROX index validity, intubation predictors, and factors associated with the ROX index. Results: Seven journals were yielded during the search. ROX index was significantly lower in the HFNC failure group at any time interval with high sensitivity and specificity in predicting intubation (p ≤  0.001). ROX index can be used to predict intubation starting at 4 hours after HFNC initiation and calculated repeatedly. Conclusion: ROX index was a good parameter in predicting intubation in COVID-19 pneumonia patients who receive HFNC. The higher value of the ROX index was associated with a higher chance of HFNC success and a lower risk of mortality. %U https://www.qscience.com/content/journals/10.5339/jemtac.2022.8