https://doi.org/10.4081/monaldi.2023.2509

Utility and timing of the respiratory rate-oxygenation index in the prediction of high-flow oxygen therapy failure in acute hypoxemic respiratory failure of infective etiology: a prospective observational study

Vol. 94 No. 1 (2024)
Submitted: December 18, 2022
Accepted: May 4, 2023
Published: May 16, 2023
High-flow oxygen therapy, respiratory failure, acute respiratory distress syndrome, ROX index
Abstract Views: 847
PDF: 244
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Authors

Pramod Chaudhari
https://orcid.org/0000-0002-7683-2634
Department of Pulmonary and Critical Care Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Pawan Kumar Singh
https://orcid.org/0000-0002-3212-9875
Department of Pulmonary and Critical Care Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Manjunath Govindagoudar
https://orcid.org/0000-0003-2704-0873
Department of Pulmonary and Critical Care Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Vinod Sharma
https://orcid.org/0000-0002-2479-2837
Department of Pulmonary and Critical Care Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Puneet Saxena
https://orcid.org/0000-0003-1111-1008
Respiratory Medicine, Research and Referral Army Hospital, New Delhi, India.
Aman Ahuja
https://orcid.org/0000-0003-0307-3427
Department of Pulmonary and Critical Care Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Lokesh Lalwani
https://orcid.org/0000-0002-7652-309X
Respiratory Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Dhruva Chaudhry
dhruvachaudhry@yahoo.co.in
https://orcid.org/0000-0001-5138-2908
Respiratory Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.

During and following the COVID-19 pandemic, the world has witnessed a surge in high-flow oxygen therapy (HFOT) use. The ability to provide high oxygenation levels with remarkable comfort levels has been the grounds for the same. Despite the advantages, delays in intubation leading to poor overall outcomes have been noticed in subgroups of patients on HFOT. The respiratory rate-oxygenation (ROX) index has been proposed to be a useful indicator to predict HFOT success. In this study, we have examined the utility of the ROX index prospectively in cases of acute hypoxemic respiratory failure (AHRF) due to infective etiologies. A total of 70 participants were screened, and 55 were recruited for the study. The majority of participants were males (56.4%), with diabetes mellitus being the most common comorbidity (29.1%). The mean age of the study subjects was 46.27±15.6 years. COVID-19 (70.9%) was the most common etiology for AHRF, followed by scrub typhus (21.8%). 19 (34.5%) experienced HFOT failure, and 9 (16.4%) subjects died during the study period. Demographic characteristics did not differ between either of the two groups (HFOT success versus failure and survived group versus expired group). The ROX index was significantly different between the HFOT success versus failure group at baseline, 2, 4, 6, 12, and 24 hours. The best cut-offs of the ROX index at baseline and 2 hours were 4.4 (sensitivity 91.7%, specificity 86.7%) and 4.3 (sensitivity 94.4% and specificity 86.7%), respectively. The ROX index was found to be an efficient tool in predicting HFOT failure in cases of AHRF with infective etiology.

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Ethics Approval

All approvals (ethical and review board) were obtained before screening the first patient. The Institutional Review Board-approved study protocol was also cleared by the Biomedical Research Ethics Committee of the Institute via approval letter number BREC/Th/20/02, dated September 2, 2020.

How to Cite

Chaudhari, Pramod, Pawan Kumar Singh, Manjunath Govindagoudar, Vinod Sharma, Puneet Saxena, Aman Ahuja, Lokesh Lalwani, and Dhruva Chaudhry. 2023. “Utility and Timing of the Respiratory Rate-Oxygenation Index in the Prediction of High-Flow Oxygen Therapy Failure in Acute Hypoxemic Respiratory Failure of Infective Etiology: A Prospective Observational Study”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2509.
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