Performance of the ROX index to predict intubation in immunocompromised patients receiving high-flow nasal cannula for acute respiratory failure.
Performance of the ROX index to predict intubation in immunocompromised patients receiving high-flow nasal cannula for acute respiratory failure.
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DOI：
10.1186/s13613-021-00801-z
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发表时间：
2021-01-27
影响因子：
8.1
通讯作者：
Groupe de Recherche en Reanimation Respiratoire du patient d’Onco-Hématologie (GRRR-OH)
中科院分区：
文献类型：
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作者：
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 D;Meert AP;Jaber S;Mokart D;Darmon M;Azoulay E;Groupe de Recherche en Reanimation Respiratoire du patient d’Onco-Hématologie (GRRR-OH)
延迟插管与高死亡率相关。目前缺乏决定插管时间的客观标准。我们评估了最近描述的综合氧合指数（ROX 指数）来预测免疫功能低下患者的插管。该研究是对免疫功能低下患者（包括所有接受高流量鼻插管（HFNC）的患者）随机试验的二次分析。第一个目标是评估 ROX 指数预测急性呼吸衰竭患者插管的准确性。在该研究中，302 名患者接受了 HFNC。急性呼吸衰竭主要与肺炎有关（n = 150，49.7%）。 2 (1–3) 天内，115 名患者 (38.1%) 接受了插管。 ICU 死亡率为 27.4% (n = 83)。 6 小时时，需要插管的患者的 ROX 指数低于不需要插管的患者 [4.79 (3.69–7.01) vs. 6.10 (4.48–8.68)，p<0.001]。 ROX 指数预测插管的准确性较差 [AUC = 0.623 (0.557–0.689)]，使用先前发现的阈值 (4.88) 的性能较低。在多变量分析中，较高的 ROX 指数仍然与较低的插管率独立相关（OR = 0.89 [0.82–0.96]，p = 0.04）。 ROX 指数大于 4.88 似乎对患有急性呼吸衰竭的免疫功能低下患者的插管预测能力较差，尽管它仍然与插管风险高度相关，并且可能有助于在未来的研究中对此类风险进行分层。
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. 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). 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.
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影响因子：
38.9
作者：
Kang, Byung Ju;Koh, Younsuck;Hong, Sang-Bum
通讯作者：
Hong, Sang-Bum
无创通气与氧气疗法对急性呼吸衰竭免疫受损患者死亡率的影响 一项随机临床试验
影响因子：
120.7
作者：
Lemiale, Virginie;Mokart, Djamel;Azoulay, Elie
通讯作者：
Azoulay, Elie
DOI：
10.1164/rccm.201803-0589oc
发表时间：
2019-06-01
影响因子：
24.7
作者：
Roca, Oriol;Caralt, Berta;Ricard, Jean-Damien
通讯作者：
Ricard, Jean-Damien
影响因子：
38.9
作者：
Duan, Jun;Han, Xiaoli;Huang, Shicong
通讯作者：
Huang, Shicong
影响因子：
8.8
作者：
Lemiale, Virginie;Resche-Rigon, Matthieu;Azoulay, Elie
通讯作者：
Azoulay, Elie