1887
Volume 2022, Issue 2
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

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 (SpO/FiO) 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.  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.  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.  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.

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2022-02-14
2024-03-28
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References

  1. Shekerdemian LS, Mahmood NR, Wolfe KK, Riggs BJ. Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units. JAMA Pediatrics. 2020;3:E1–6.
    [Google Scholar]
  2. World Health Organization. WHO coronavirus disease (COVID-19) dashboard: February 8, 2021. https://covid19.who.int/ Accessed February 8, 2021.
    [Google Scholar]
  3. Cruz AT, Zeichner SL. COVID-19 in children: Initial characterization of the pediatric disease. Pediatrics. 2020; 145:(6):1–2.
    [Google Scholar]
  4. Guy T, Creac'hcadec A, Ricordel C, Sale A, Arnouat B, Bizec JL, et al. High-flow nasal oxygen: a safe, efficient treatment for COVID-19 patients not in an ICU. European Respiratory Journal. 2020 56:(5):2001154.
    [Google Scholar]
  5. Kaya AG, Oz Mirac, Erol S, Ciftci S, Ciledag A, Kaya A. High flow nasal cannula in COVID-19: a literature review. Tuberk Toraks. 2020 68:(2):168–174.
    [Google Scholar]
  6. Leeies M, Flynn E, Turgeon AF, Paunovic B, Loewen H, Rabbani R. High-flow oxygen via nasal cannulae in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis. Syst Rev. 2017;6:202.
    [Google Scholar]
  7. Papazian L, Corley A, Hess D, Fraser JF, Frat JP, Guitton C, et al. Use of high-flow nasal cannula oxygenation in ICU adults: a narrative review. Intensive Care Med. 2016 42:(9):1336–49.
    [Google Scholar]
  8. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020 8:(5):475–81.
    [Google Scholar]
  9. Hernández G, Vaquero C, González P, Subira C, Vivar FF, Rialp G, et al. Effect of postextubation high-flow nasal cannula vs conventional oxygen therapy on reintubation in low-risk patients: a randomized clinical trial. JAMA. 2016 315:(13):1354–61.
    [Google Scholar]
  10. Kim WY, Sung H, Hong SB, Lim CM, Koh Y, Huh JW. Predictors of high flow nasal cannula failure in immunocompromised patients with acute respiratory failure due to non-HIV pneumocystis pneumonia. J Thorac Dis. 2017 Sep; 9:(9):3013–3022. doi: 10.21037/jtd.2017.08.09 .
    [Google Scholar]
  11. Roca O, Caralt B, Messika J, Samper M, Sztrymf B, Hernandez G, et al. An index combining respiratory rate and oxygenation to predict outcome of nasal high-flow therapy. Am J Respir Crit Care Med. 2019 199:(11):1368–76.
    [Google Scholar]
  12. Frat JP, Ragot S, Coudroy R, Constantin JM, Girault C, Prat G, et al. Predictors of intubation in patients with acute hypoxemic respiratory failure treated with a noninvasive oxygenation strategy. Crit Care Med. 2018 46:(2):208–15.
    [Google Scholar]
  13. Goh KJ, Chai HZ, Ong TH, Sewa DW, Phua GC, Tan QL, et al. Early prediction of high flow nasal cannula therapy outcomes using a modified ROX index incorporating heart rate. Journal of Intensive Care. 2020 41:(8):1–14.
    [Google Scholar]
  14. Patel M, Chowdhury J, Mills N, Marron R, Gangemi A, Dorey-Stein Z, Yousef I, Zheng M, Tragesser L, Giurintano J, Gupta R, Rali P, D'Alonzo G, Zhao H, Patlakh N, Marchetti N, Criner G, Gordon M. Utility of the ROX Index in Predicting Intubation for Patients With COVID-19-Related Hypoxemic Respiratory Failure Receiving High-Flow Nasal Therapy: Retrospective Cohort Study. JMIRx Med. 2021 Aug 27; 2:(3):e29062. doi: 10.2196/29062 .
    [Google Scholar]
  15. Suliman LA, Abdelgawad TT, Farrag NS, Abdelwahab HW. Validity of ROX index in prediction of risk of intubation in patients with COVID-19 pneumonia. Adv Respir Med. 2021 89:(1):1–7.
    [Google Scholar]
  16. Panadero C, Fernandez AA, Ramirez MTR, Gutierrez CMA, Alcala MC, Riolobos CL, et al. High-flow nasal cannula for acute respiratory distress syndrome (ARDS) due to COVID-19. Multidisciplinary Respiratory Medicine. 2020 693:(15):103–8.
    [Google Scholar]
  17. Chandel A, Patolia S, Brown AW, Collins AC, Sahjwani D, Khangoora V, et al. High-flow nasal cannula in COVID-19: outcomes of application and examination of the ROX index to predict success. Respiratory Care. 2020:1–33.
    [Google Scholar]
  18. Hu M, Zhou Q, Zheng RQ, Li XY, Ling JM, Chen YM, et al. Application of high-flow nasal cannula in hypoxemic patients with COVID-19: a retrospective cohort study. BMC Pulm Med. 2020 20:(1):324.
    [Google Scholar]
  19. Xu JQ, Yang XB, Huang CL, Zou XJ, Zhou T, Pan SW, et al. A novel risk-stratification models of the high-flow nasal cannula therapy in COVID-19 patients with hypoxemic respiratory failure. Frontiers in Medicine. 2020;7:1–9.
    [Google Scholar]
  20. Calligaro GL, Lalla U, Audley G, Gina P, Miller MG, Mendelson M, et al. The utility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: a multi-centre prospective observational study HFNO for COVID-19 pneumonia. EClinicalMedicine. 2020;28:100570.
    [Google Scholar]
  21. Roca O, Messika J, Caralt B, Acilu MG, Sztrymf B, Ricard JD, et al. Predicting success of high-flow nasal cannula in pneumonia patients with hypoxemic respiratory failure: The utility of the ROX index. J Crit Care. 2016;35:200–5.
    [Google Scholar]
  22. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S, et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. New England Journal for Medicine. 2015;56:3446.
    [Google Scholar]
  23. Raoof S, Nava S, Carpati C, Hill NS. High-flow, noninvasive ventilation and awake (nonintubation) proning in patients with coronavirus disease 2019 with respiratory failure. Chest. 2020 158:(5):1992–2002.
    [Google Scholar]
  24. Kang BJ, Koh Y, Lim CM, Huh JW, Baek SH, Han MJ, et al. Failure of high-flow nasal cannula therapy may delay intubation and increase mortality. Intensive Care Med. 2015 41:(4):623–32.
    [Google Scholar]
  25. Zucman N, Mullaert J, Roux D, Roca O, Ricard JD. Prediction of outcome of nasal high flow use during COVID-19 related acute hypoxemic respiratory failure. Intensive Care Med. 2020;372:2185–96.
    [Google Scholar]
  26. Tatkov S. Nasal high-flow therapy: role of FiO2 in the ROX index. American Thoracic Society. 2019; 1:(1):115–6.
    [Google Scholar]
  27. Ruan Q, Yang K., Wang W, Jiang L, Song J, et al. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020 46:(5):846–8.
    [Google Scholar]
  28. Lemiale V, Dumas G, Demoule A, Pene F, Kouatchet A, Bisbal M, et al. Performance of the ROX index to predict intubation in immunocompromised patients receiving high-flow nasal cannula for acute respiratory failure. Ann Intensive Care. 2021 17:(11):1–9.
    [Google Scholar]
  29. Rodriguez M, Thille AW, Boissier F, Veinstein A, Chatellier D, Robert R, et al. Predictors of successful separation from high-flow nasal oxygen therapy in patients with acute respiratory failure: a retrospective monocenter study. Ann Intensive Care. 2019 101:(9):1–7.
    [Google Scholar]
  30. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;323:1061.
    [Google Scholar]
  31. Mueller AA, Tamura T, Crowley CP, DeGrade JR, Haider H, Jezmir JL, et al. Inflammatory biomarker trends predict respiratory decline in COVID-19 patients. Cell Reports Medicine. 2020 1:(8):100144.
    [Google Scholar]
  32. Hartmann J, Ergang A, Mason D, Dias JD. The role of TEG analysis in patients with COVID-19-associated coagulopathy: a systematic review. Diagnostics. 2021 172:(11):1–13.
    [Google Scholar]
  33. Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, et al. Hypercoagulability of COVID-19 patients in intensive care unit: a report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost. 2020 18:(7):1738–42.
    [Google Scholar]
  34. Saseedharan S, Talla VB, Chiluka A. Thromboelastography profile of patients with COVID-19 admitted to intensive care unit: a single-center retrospective study from India. Indian Journal of Critical Care Medicine. 2020 24:(12):1219–22.
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): COVID-19high flow nasal cannulaintubationpneumonia and ROX index
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