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Colegio de Medicina Interna de México.

2023, Number 3

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Med Int Mex 2023; 39 (3)

ROX index and predictors of failure to highflow nasal prongs in COVID-19 patients and resistant hypoxemia

Revuelta-Rodríguez LA, Dector-Lira DM

Language: Spanish
References: 14
Page: 423-429
PDF size: 191.38 Kb.


ABSTRACT

Objective: To assess whether there is an association between clinical variables and failure to use high-flow nasal prongs in patients with refractory hypoxemia and COVID-19.
Materials and Methods: An observational, retrospective study was done including patients older than 18 years, admitted to the intensive care area of the Dalinde Medical Center, Mexico City, from June to December 2020, who had a positive PCR for SARSCoV- 2, who determined severe illness or critical illness with refractory hypoxemia and who underwent to high-flow nasal prongs; the percentage of failure (need for invasive mechanical ventilation or death) or success (hospital discharge) was obtained and the association of each variable among patients with failure or success was analyzed, as well as ROX index (IROX), defined as relation of O2 saturation by pulse oximetry, fraction of inspired O2 and respiratory rate.
Results: There were included 50 patients. There was a significant difference in IROX at 7 days (4.14 vs 7.28), D-dimer at 72 hours (5.24 vs 1.68), ferritin at 72 hours (1840.18 vs 1071.89), leukocytes at 7 days (13.78 vs 8.66) and in the initial PCR (167.75 vs 113.2), but not in the rest of the variables.
Conclusions: There are variables that could help predict which patients are at higher risk of failing high-flow nasal prongs, thus preventing delay in advanced airway management.


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