Respiratory Rate Oxygenation (ROX) index as predictor of high flow nasal cannula in pediatric patients in pediatric intensive care unit.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968563 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2466 (Electronic) Linking ISSN: 14712466 NLM ISO Abbreviation: BMC Pulm Med Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001]-

Intensive Care Units, Pediatric* ; Cannula* ; Oxygen Inhalation Therapy*/methods ; Respiratory Rate*; Humans ; Child ; Cross-Sectional Studies ; Male ; Infant ; Child, Preschool ; Female ; Adolescent ; ROC Curve ; Reproducibility of Results ; Treatment Failure ; Respiratory Insufficiency/therapy

Background: High-flow nasal cannula (HFNC) is often used in pediatric populations with respiratory distress. In adults, the respiratory-rate oxygenation (ROX) index is used as a predictor of HFNC therapy; however, children have age-associated differences in respiratory rate, thus may not be applicable to children. This study aims to find the reliability of ROX index and modified P-ROX index as predictors of HFNC therapy failure in pediatric patients.
Methods: Subjects in this analytical cross-sectional study were taken from January 2023 until November 2023 in Cipto Mangunkusumo Hospital. Inclusion criteria are children aged 1 month to 18 years with respiratory distress and got HFNC therapy. Receiver operating characteristics (ROC) analysis was used to find mP-ROX index cutoff value as a predictor of HFNC failure. The area under curve (AUC) score of mP-ROX index was assessed at different time point.
Results: A total of 102 patients, with 70% of the population with pneumonia, were included in this study. There are significant differences in the ROX index between the successful and failed HFNC group therapy (p < 0.05). This study suggests that mP-ROX index is not useful as predictor of HFNC therapy in pediatrics. While ROX index < 5.52 at 60 min and < 5.68 at 90 min after HFNC initiation have a sensitivity of 90% and specificity of 71%, sensitivity of 78% and specificity of 76%, respectively.
Conclusion: mP-ROX index is not useful as a predictor of HFNC therapy in pediatrics. Meanwhile, ROX index at 60 min and 90 min after initiation of HFNC is useful as a predictor of HFNC failure.
(© 2024. The Author(s).)

BMJ Open. 2023 Mar 30;13(3):e067879. (PMID: 36997243)
Pediatr Int. 2022 Jan;64(1):e15336. (PMID: 36564344)
Lancet. 2011 Mar 19;377(9770):1011-8. (PMID: 21411136)
Ann Intensive Care. 2021 Jan 27;11(1):17. (PMID: 33501590)
Ann Intensive Care. 2014 Sep 30;4:29. (PMID: 25593745)
Sci Rep. 2024 Jan 3;14(1):389. (PMID: 38172405)
Respir Res. 2022 Feb 17;23(1):33. (PMID: 35177091)
Am J Respir Crit Care Med. 2019 Jun 1;199(11):1368-1376. (PMID: 30576221)
PLoS One. 2022 May 12;17(5):e0268431. (PMID: 35551328)
Front Pediatr. 2021 May 07;9:664180. (PMID: 34026694)
Pediatr Emerg Care. 2012 Nov;28(11):1117-23. (PMID: 23114231)
Eur J Pediatr. 2021 Apr;180(4):1099-1106. (PMID: 33078280)
Pediatr Pulmonol. 2018 Jun;53(6):809-815. (PMID: 29528202)
Clin Exp Pediatr. 2020 Jan;63(1):3-7. (PMID: 31999912)
Sultan Qaboos Univ Med J. 2018 Aug;18(3):e278-e285. (PMID: 30607266)
Ther Adv Respir Dis. 2020 Jan-Dec;14:1753466620956459. (PMID: 32976085)
Eur J Pediatr. 2022 Nov;181(11):3977-3983. (PMID: 36102995)
Clin Exp Pediatr. 2022 Dec;65(12):595-601. (PMID: 36457201)

Keywords: HFNC; Pediatrics; ROX index

Date Created: 20240502 Date Completed: 20240502 Latest Revision: 20240505

20240505

PMC11067281

10.1186/s12890-024-03029-2

38698400