Related Experiment Video
Updated: May 19, 2025
Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
A retrospective study to predict failure of high-flow oxygen therapy for acute hypoxic respiratory failure
Mingming Xue1, Fengqing Liao1, Feixiang Xu1
1Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Objective:
This study aimed to analyze the characteristics of patients who fail high-flow nasal cannula(HFNC) therapy for acute hypoxemic respiratory failure(AHRF) and to identify predictors of treatment failure.
Methods:
This single-center, retrospective, observational study analyzed clinical data from 388 patients with AHRF. Patients were divided into two groups: the HFNC success group (HFNC-S, n = 256) and the HFNC failure group (HFNC-F, n = 132). The primary endpoint was the need for escalation of respiratory support to tracheal intubation in the enrolled patients. The demographic data, laboratory tests, blood gas analysis data, CT severity scores, and disease severity scores were analysed to determine the difference between patients who were successful and those who failed HFNC treatment. Univariate and multivariate logistic regression models were used to assess potential predictors of failure of HFNC for patients with acute hypoxaemic respiratory failure.
Results:
The mean age of patients enrolled was 67.97 ± 14.40 years. The HFNC-F group had significantly higher PSI(Pneumonia Severity Index) score, CURB(Confusion, Urea, Respiratory Rate, Blood Pressure, and Age)-65 score, CPIS(Clinical Pulmonary Infection Score) score, CT score and SOFA(Sequential Organ Failure Assessment) scores compared to the HFNC-S group. Within 12 h of the initiation of treatment, the HFNC-F group exhibited significantly lower oxygen saturation index (PaO2/FiO2) and significantly higher respiratory rate. Additionally, the HFNC-F group exhibited significantly higher levels of C-reactive protein (CRP), platelet count (PLT), D-dimer, interleukin-10 (IL-10), total bilirubin (TB) and creatinine (CB), but lower albumin levels. Multivariate analysis identified CT score, SOFA score, interleukin-1β (IL-1β), and albumin as independent predictors of HFNC failure.
Conclusion:
HFNC is effective for treating AHRF. CT score, SOFA score, IL-1β, and albumin are independent predictors of HFNC failure.
Related Concept Videos
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:21Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
01:23Acute Respiratory Failure-IV
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...