The Respiratory Rate-Oxygenation Index predicts failure of post-extubation high-flow nasal cannula therapy in intensive care unit patients: a retrospective cohort study / Santiago Cardona Marín    

Público ISBD Título : The Respiratory Rate-Oxygenation Index predicts failure of post-extubation high-flow nasal cannula therapy in intensive care unit patients: a retrospective cohort study Tipo de documento : documento electrónico Autores : Santiago Cardona Marín, Fecha de publicación : 2022 Títulos uniformes : Revista Brasileira de Terapia Intensiva Idioma : Inglés (eng) Palabras clave : Cannula  Oxygenation  Respiratory rate  Airway extubation  Pneumonia  Critical care  Intensive care units Resumen : Objective: To investigate the applicability of the Respiratory Rate-Oxygenation Index to identify the risk of high-flow nasal cannula failure in post-extubation pneumonia patients. Methods: This was a 2-year retrospective observational study conducted in a reference hospital in Bogotá, Colombia. All patients in whom post-extubation high-flow nasal cannula therapy was used as a bridge to extubation were included in the study. The Respiratory Rate-Oxygenation Index was calculated to assess the risk of post-extubation high-flow nasal cannula failure. Results: A total of 162 patients were included in the study. Of these, 23.5% developed high-flow nasal cannula failure. The Respiratory Rate-Oxygenation Index was significantly lower in patients who had high-flow nasal cannula failure [median (IQR): 10.0 (7.7 - 14.4) versus 12.6 (10.1 - 15.6); p = 0.006]. Respiratory Rate-Oxygenation Index > 4.88 showed a crude OR of 0.23 (95%CI 0.17 - 0.30) and an adjusted OR of 0.89 (95%CI 0.81 - 0.98) stratified by severity and comorbidity. After logistic regression analysis, the Respiratory Rate-Oxygenation Index had an adjusted OR of 0.90 (95%CI 0.82 - 0.98; p = 0.026). The area under the Receiver Operating Characteristic curve for extubation failure was 0.64 (95%CI 0.53 - 0.75; p = 0.06). The Respiratory Rate-Oxygenation Index did not show differences between patients who survived and those who died during the intensive care unit stay. Conclusion: The Respiratory Rate-Oxygenation Index is an accessible tool to identify patients at risk of failing high-flow nasal cannula post-extubation treatment. Prospective studies are needed to broaden the utility in this scenario. Mención de responsabilidad : Yuli V. Fuentes, Katherine Carvajal, Santiago Cardona, Gina Sofia Montaño, Elsa D. Ibáñez-Prada, Alirio Bastidas, Eder Caceres, Ricardo Buitrago, Marcela Poveda, Luis Felipe Reyes Referencia : Rev Bras Ter Intensiva. 2022 Sep 19;34(3):360-366. DOI (Digital Object Identifier) : 10.5935/0103-507X.20220477-en PMID : 36134847 Derechos de uso : CC BY En línea : http://rbti.org.br/artigo/detalhes/0103507X-34-3-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6104 The Respiratory Rate-Oxygenation Index predicts failure of post-extubation high-flow nasal cannula therapy in intensive care unit patients: a retrospective cohort study [documento electrónico] / Santiago Cardona Marín,  . - 2022. Obra : Revista Brasileira de Terapia Intensiva Idioma : Inglés (eng) Palabras clave : Cannula  Oxygenation  Respiratory rate  Airway extubation  Pneumonia  Critical care  Intensive care units Resumen : Objective: To investigate the applicability of the Respiratory Rate-Oxygenation Index to identify the risk of high-flow nasal cannula failure in post-extubation pneumonia patients. Methods: This was a 2-year retrospective observational study conducted in a reference hospital in Bogotá, Colombia. All patients in whom post-extubation high-flow nasal cannula therapy was used as a bridge to extubation were included in the study. The Respiratory Rate-Oxygenation Index was calculated to assess the risk of post-extubation high-flow nasal cannula failure. Results: A total of 162 patients were included in the study. Of these, 23.5% developed high-flow nasal cannula failure. The Respiratory Rate-Oxygenation Index was significantly lower in patients who had high-flow nasal cannula failure [median (IQR): 10.0 (7.7 - 14.4) versus 12.6 (10.1 - 15.6); p = 0.006]. Respiratory Rate-Oxygenation Index > 4.88 showed a crude OR of 0.23 (95%CI 0.17 - 0.30) and an adjusted OR of 0.89 (95%CI 0.81 - 0.98) stratified by severity and comorbidity. After logistic regression analysis, the Respiratory Rate-Oxygenation Index had an adjusted OR of 0.90 (95%CI 0.82 - 0.98; p = 0.026). The area under the Receiver Operating Characteristic curve for extubation failure was 0.64 (95%CI 0.53 - 0.75; p = 0.06). The Respiratory Rate-Oxygenation Index did not show differences between patients who survived and those who died during the intensive care unit stay. Conclusion: The Respiratory Rate-Oxygenation Index is an accessible tool to identify patients at risk of failing high-flow nasal cannula post-extubation treatment. Prospective studies are needed to broaden the utility in this scenario. Mención de responsabilidad : Yuli V. Fuentes, Katherine Carvajal, Santiago Cardona, Gina Sofia Montaño, Elsa D. Ibáñez-Prada, Alirio Bastidas, Eder Caceres, Ricardo Buitrago, Marcela Poveda, Luis Felipe Reyes Referencia : Rev Bras Ter Intensiva. 2022 Sep 19;34(3):360-366. DOI (Digital Object Identifier) : 10.5935/0103-507X.20220477-en PMID : 36134847 Derechos de uso : CC BY En línea : http://rbti.org.br/artigo/detalhes/0103507X-34-3-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6104

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