Evidence map›Paper›PMID 38958373›Full record

Observational studyCritical care science2024

The respiratory oxygenation index for identifying the risk of orotracheal intubation in COVID-19 patients receiving high-flow nasal cannula oxygen.

Aline Braz Pereira, Felipe Dal Pizzol, Viviane Cordeiro Veiga, Leandro Utino Taniguchi, Aline Finoti Misquita, Gustavo Augusto Couto Carvalho, Ligia Maria Coscrato Junqueira Silva, Michelli Marcela Dadam, Ruthy Perotto Fernandes, Israel Silva Maia and 4 more

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Critical care science, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Aline Braz PereiraIntensive Care Unit, Centro Hospitalar Unimed - Joinville (SC), Brazil.ORCID http://orcid.org/0000-0001-8440-0228
Felipe Dal PizzolPostgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.ORCID http://orcid.org/0000-0003-3003-8977
Viviane Cordeiro VeigaIntensive Care Unit, BP - A Beneficência Portuguesa de São Paulo - São Paulo (SP), Brazil.ORCID http://orcid.org/0000-0002-0287-3601
Leandro Utino TaniguchiIntensive Care Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brazil.ORCID http://orcid.org/0000-0003-4384-0408
Aline Finoti MisquitaIntensive Care Unit, BP - A Beneficência Portuguesa de São Paulo - São Paulo (SP), Brazil.ORCID http://orcid.org/0009-0009-2105-516X
Gustavo Augusto Couto CarvalhoIntensive Care Unit, BP - A Beneficência Portuguesa de São Paulo - São Paulo (SP), Brazil.ORCID http://orcid.org/0009-0006-8423-0410
Ligia Maria Coscrato Junqueira SilvaIntensive Care Unit, BP - A Beneficência Portuguesa de São Paulo - São Paulo (SP), Brazil.ORCID http://orcid.org/0000-0001-7436-1843
Michelli Marcela DadamIntensive Care Unit, Hospital Municipal São José - Joinville (SC), Brazil.ORCID http://orcid.org/0000-0001-7029-5754
Ruthy Perotto FernandesIntensive Care Unit, Centro Hospitalar Unimed - Joinville (SC), Brazil.ORCID http://orcid.org/0009-0009-5546-9432
Israel Silva MaiaIntensive Care Unit, Hospital Nereu Ramos - Florianópolis, Santa Catarina (SC), Brazil.ORCID http://orcid.org/0000-0003-3467-5287
Cassio Luis ZandonaiIntensive Care Unit, Hospital Nereu Ramos - Florianópolis, Santa Catarina (SC), Brazil.ORCID http://orcid.org/0009-0002-7855-1868
Alexandre Biasi CavalcantiIntensive Care Unit, Hcor-Hospital do Coração, Associação Beneficente Síria - São Paulo (SP), Brazil.ORCID http://orcid.org/0000-0003-2798-6263
Marcelo Luz Pereira RomanoIntensive Care Unit, Hcor-Hospital do Coração, Associação Beneficente Síria - São Paulo (SP), Brazil.ORCID http://orcid.org/0000-0001-6773-1666
Glauco Adrieno WestphalIntensive Care Unit, Centro Hospitalar Unimed - Joinville (SC), Brazil.ORCID http://orcid.org/0000-0001-9581-7141

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess whether the respiratory oxygenation index (ROX index) measured after the start of high-flow nasal cannula oxygen therapy can help identify the need for intubation in patients with acute respiratory failure due to coronavirus disease 2019.

methodsThis retrospective, observational, multicenter study was conducted at the intensive care units of six Brazilian hospitals from March to December 2020. The primary outcome was the need for intubation up to 7 days after starting the high-flow nasal cannula.

resultsA total of 444 patients were included in the study, and 261 (58.7%) were subjected to intubation. An analysis of the area under the receiver operating characteristic curve (AUROC) showed that the ability to discriminate between successful and failed high-flow nasal cannula oxygen therapy within 7 days was greater for the ROX index measured at 24 hours (AUROC 0.80; 95%CI 0.76 - 0.84). The median interval between high-flow nasal cannula initiation and intubation was 24 hours (24 - 72), and the most accurate predictor of intubation obtained before 24 hours was the ROX index measured at 12 hours (AUROC 0.75; 95%CI 0.70 - 0.79). Kaplan-Meier curves revealed a greater probability of intubation within 7 days in patients with a ROX index ≤ 5.54 at 12 hours (hazard ratio 3.07; 95%CI 2.24 - 4.20) and ≤ 5.96 at 24 hours (hazard ratio 5.15; 95%CI 3.65 - 7.27).

conclusionThe ROX index can aid in the early identification of patients with acute respiratory failure due to COVID-19 who will progress to the failure of high-flow nasal cannula supportive therapy and the need for intubation.

Indexed as

CannulaCOVID-19Intubation, IntratrachealOxygen Inhalation TherapyAgedBrazilFemaleHumansIntensive Care UnitsMaleMiddle AgedRespiratory InsufficiencyRetrospective StudiesSARS-CoV-2

Identifiers

PMID38958373
PMCPMC11208043

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.