呼吸速率-氧化率 (ROX) 指数用于预测COVID-19患者和没有COVID-19患者的高流量鼻失效
Hyojeong Kwon1, Seung Won Ha1, Boram Kim2
1Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
ROX指数有效地预测了COVID-19和没有COVID-19的急性缺血性呼吸衰竭 (AHRF) 患者的高流量鼻腔管 (HFNC) 衰竭. 然而,最佳值在不同组之间存在差异,特别是对于那些不在ICU之外的人.
科学领域:
- 紧急医疗 紧急医疗
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
背景情况:
- 在急性缺血性呼吸衰竭 (AHRF) 中,高流量鼻 (HFNC) 衰竭的呼吸速率-氧化 (ROX) 指数的预测值可能在COVID-19和非COVID-19患者之间有所不同.
- 这些群体之间以前的比较缺乏.
研究的目的:
- 为了比较ROX指数的诊断准确性,用于预测在急诊室 (ED) 访问期间在COVID-19和没有COVID-19的AHRF患者中HFNC失败.
主要方法:
- 在ED中接受HFNC治疗的448名AHRF患者的回顾性分析.
- 在HFNC启动后的多个时间点 (1-24小时) 计算的ROX指数.
- 接收器操作特征 (ROC) 曲线用于评估HFNC故障的判别力 (定义为需要在72小时内输管或死亡).
主要成果:
- 在COVID-19 (33.3%) 和非COVID-19 (29.5%) 组之间,HFNC失败率没有显著差异.
- 罗克斯指数预后功率 (AUC) 在COVID-19组 (0.73-0.83) 一般高于非COVID-19组 (0.62-0.75).
- 预测失败的最佳ROX指数截止值为COVID-19患者的5.79和非COVID-19患者的6.48.
结论:
- 罗克斯指数表明,在ED的COVID-19和非COVID-19AHRF患者中,HFNC失败的可接受的区分能力.
- 与之前的ICU研究相比,观察到更高的最佳ROX指数值表明需要在非ICU环境中调整值.
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