Predictors of Nasal High-flow Humidified Oxygen Therapy Failure: A Narrative Review
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i1.3707
Abstract
High-flow nasal cannula oxygen therapy (HFNC) is a widely used non-invasive respiratory support for patients with mild acute hypoxemic respiratory failure (AHRF). Early identification of HFNC failure risk can facilitate timely intervention and avoid poor outcomes. Currently, there is a paucity of reliable predicators to predict HFNC failure. Roca et al. introduced the ROX index as a predictor of intubation risk in pneumonia patients undergoing HFNC. Subsequently, various modified predictors have been proposed to address limitations of the ROX index; however, their predictive performance remained under investigation and had not yet been universally validated. In this study, we investigated and analyzed the development and current application status of known HFNC failure predictors to provide ideas and recommendations on further relevant researches.
Keywords
high-flow nasal cannula oxygen therapy, acute hypoxemic respiratory failure, risk prediction, the ROX index
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[2] J.B. Waugh, W.M. Granger. An evaluation of 2 new devices for nasal high-flow gas therapy. Respiratory Care. 2004; 49(8):902-906.
[3] H.J. Kim, T. Asai. High-flow nasal oxygenation for anesthetic management. Korean Journal of Anesthesiology. 2019; 72(6):527-547.
[4] R. Coudroy, J. Frat, S. Ehrmann, F. Pène, M. Decavèle, N. Terzi, G. Prat et al. High-flow nasal oxygen alone or alternating with non-invasive ventilation in critically ill immunocompromised patients with acute respiratory failure: a randomised controlled trial. Lancet Respiratory Medicine. 2022; 10(7):641-649.
[5] S. Oczkowski, B. Ergan, L. Bos, M. Chatwin, M. Ferrer, C. Gregoretti, L. Heunks et al. ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure. EUROPEAN RESPIRATORY JOURNAL. 2022; 59(4):
[6] J. Helms, P. Catoire, L. Abensur Vuillaume, H. Bannelier, D. Douillet, C. Dupuis, L. Federici et al. Oxygen therapy in acute hypoxemic respiratory failure: guidelines from the SRLF-SFMU consensus conference. Annals of Intensive Care. 2024; 14(1):140.
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[8] H. Yang, D. Huang, J. Luo, Z. Liang, J. Li. The use of high-flow nasal cannula in patients with chronic obstructive pulmonary disease under exacerbation and stable phases: A systematic review and meta-analysis. HEART & LUNG. 2023; 60(116-126.
[9] E. Besnier, S. Hobeika, S. NSeir, F. Lambiotte, D. Du Cheyron, B. Sauneuf, B. Misset et al. High-flow nasal cannula therapy: clinical practice in intensive care units. Annals of Intensive Care. 2019; 9(1):98.
[10] O. Roca, G. Hernández, S. Díaz-Lobato, J.M. Carratalá, R.M. Gutiérrez, J.R. Masclans. Current evidence for the effectiveness of heated and humidified high flow nasal cannula supportive therapy in adult patients with respiratory failure. CRITICAL CARE. 2016; 20(1):109.
[11] O. Roca, B. Caralt, J. Messika, M. Samper, B. Sztrymf, G. Hernández, M. García-de-Acilu et al. An Index Combining Respiratory Rate and Oxygenation to Predict Outcome of Nasal High-Flow Therapy. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE. 2019; 199(11):1368-1376.
[12] V. Lemiale, G. Dumas, A. Demoule, F. Pène, A. Kouatchet, M. Bisbal, S. Nseir et al. Performance of the ROX index to predict intubation in immunocompromised patients receiving high-flow nasal cannula for acute respiratory failure. Annals of Intensive Care. 2021; 11(1):17.
[13] B.Z. Schaeffer, S.A. Fazio, J.C. Stocking, J.Y. Adams, A. Liu, H.B. Black, R.W. Harper et al. Using the ROX Index to Predict Treatment Outcome for High-Flow Nasal Cannula and/or Noninvasive Ventilation in Patients With COPD Exacerbations. Respiratory Care. 2024; 69(9):1100-1107.
[14] A. Li, M.E. Cove, J. Phua, S.H. Puah, V. Ng, A. Kansal, Q.L. Tan et al. Expanding the utility of the ROX index among patients with acute hypoxemic respiratory failure. PLoS One. 2022; 17(4):e0261234.
[15] C. Deana, M. Vecchiato, F. Bellocchio, A. Tullio, A. Martino, A. Ziccarelli, V. Patruno et al. High flow nasal oxygen vs. conventional oxygen therapy over respiratory oxygenation index after esophagectomy: an observational study. Journal of Thoracic Disease. 2024; 16(2):997-1008.
[16] X. Zhou, J. Liu, J. Pan, Z. Xu, J. Xu. The ROX index as a predictor of high-flow nasal cannula outcome in pneumonia patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis. BMC Pulmonary Medicine. 2022; 22(1):121.
[17] B.K. Kim, S. Kim, C.Y. Kim, J. Cha, Y.S. Lee, Y. Ko, W.G. Kwack et al. Factors Associated With Failure of High-Flow Nasal Cannula. Respiratory Care. 2020; 65(9):1276-1284.
[18] L. Papazian, A. Corley, D. Hess, J.F. Fraser, J. Frat, C. Guitton, S. Jaber et al. Use of high-flow nasal cannula oxygenation in ICU adults: a narrative review. INTENSIVE CARE MEDICINE. 2016; 42(9):1336-1349.
[19] H.M.R. Karim, A.M. Esquinas. Success or Failure of High-Flow Nasal Oxygen Therapy: The ROX Index Is Good, but a Modified ROX Index May Be Better. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE. 2019; 200(1):116-117.
[20] F. Montecchia, F. Midulla, P. Papoff. A flow-leak correction algorithm for pneumotachographic work-of-breathing measurement during high-flow nasal cannula oxygen therapy. MEDICAL ENGINEERING & PHYSICS. 2018; 54(32-43.
[21] A. Grünewaldt, M. Gaillard, G. Rohde. Predictors of high-flow nasal cannula (HFNC) failure in severe community-acquired pneumonia or COVID-19. Internal and Emergency Medicine. 2024; 10-1007.
[22] S.T. Calle-Peña, E.D. Diaz Tavara, E. Aguirre-Milachay, D.A. León-Figueroa, M.J. Valladares-Garrido. Predictors of high-flow nasal cannula failure in COVID-19 patients in a northern Peruvian hospital. BMC Pulmonary Medicine. 2024; 24(1):414.
[23] X. Wang, Z. Zhang, W. Cao. Value of modified ROX index in predicting the outcome of patients with acute respiratory distress syndrome due to SARS-CoV-2 infection treated with high-flow nasal cannula oxygen therapy. Zhonghua wei zhong bing ji jiu yi xue. 2024; 36(6):585-590.
[24] Y. Kang, H.M. Jung, S.P. Chung, H.S. Chung, Y. Cho. Failure Prediction of High-Flow Nasal Cannula at the Conventional Oxygen Therapy Phase in the Emergency Department. Respiration; international review of thoracic diseases. 2024; 103(8):488-495.
[25] T. Liu, Y. Duan, Y. Li, Y. Hu, L. Su, A. Zhang. ChatGPT achieves comparable accuracy to specialist physicians in predicting the efficacy of high-flow oxygen therapy. Heliyon. 2024; 10(11):e31750.
[26] M. Castro-Sayat, N. Colaianni-Alfonso, L. Vetrugno, G. Olaizola, C. Benay, F. Herrera, Y. Saá et al. Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort study. The ultrasound journal. 2024; 16(1):20.
[27] P. Ruchiwit, K. Pongtongkam, N. Saiphoklang. dCROX and ROX Indices Predict Clinical Outcomes in Patients with COVID-19 Pneumonia Treated with High-Flow Nasal Cannula Oxygen Therapy. Critical Care Research and Practice. 2024; 2024(8880259.
[28] H. Okano, R. Yamamoto, Y. Iwasaki, D. Irimada, D. Konno, T. Tanaka, T. Oishi et al. External validation of the HACOR score and ROX index for predicting treatment failure in patients with coronavirus disease 2019 pneumonia managed on high-flow nasal cannula therapy: a multicenter retrospective observational study in Japan. Journal of Intensive Care. 2024; 12(1):7.
[29] P. Ruchiwit, J. Madua, N. Saiphoklang. Comparison of ROX, HROX, and delta-HR indices to predict successful weaning from high-flow oxygen therapy in hospitalized patients with COVID-19 pneumonia. PLoS One. 2024; 19(2):e0297624.
[30] P. Michel, P. Claudia, R. Andrea, D. Maria, R. Henry. Oxygen debt as a predictor of high-flow nasal cannula therapy failure in SARS-CoV-2 patients with acute respiratory failure: A retrospective cohort study. Heart & lung : the journal of critical care. 2024; 64(176-181.
[31] Y. Liu, C. Xu, Y. Huang. Early clinical application and prediction of ROX index in patients with high-flow nasal canula oxygen therapy. Zhonghua wei zhong bing ji jiu yi xue. 2023; 35(8):823-827.
[32] O. Ruangsomboon, S. Jirathanavichai, N. Phanprasert, C. Puchongmart, P. Boonmee, N. Thirawattanasoot, T. Dorongthom et al. Ratio of Oxygen Saturation to Inspired Oxygen, ROX Index, Modified ROX Index to Predict High Flow Cannula Success in COVID-19 Patients: Multicenter Validation Study. The western journal of emergency medicine. 2023; 24(3):511-521.
[33] P. Yu, C. Chen, C. Wang, K. Kuo, J. Wu, H. Chung, Y. Chen et al. Predicting the successful application of high-flow nasal oxygen cannula in patients with COVID-19 respiratory failure: a retrospective analysis. Expert Review of Respiratory Medicine. 2023; 17(4):319-328.
[34] N. Praphruetkit, N. Boonchana, A. Monsomboon, O. Ruangsomboon. ROX index versus HACOR scale in predicting success and failure of high-flow nasal cannula in the emergency department for patients with acute hypoxemic respiratory failure: a prospective observational study. International Journal of Emergency Medicine. 2023; 16(1):3.
[35] M. Bruna, G. Hidalgo, S. Castañeda, M. Galvez, D. Bravo, R. Benitez, R. Tobar et al. Diaphragmatic Ultrasound Predictors of High-Flow Nasal Cannula Therapeutic Failure in Critically Ill Patients With SARS-CoV-2 Pneumonia. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2023; 42(6):1277-1284.
[36] F. Abroug, Z. Hammouda, M. Lahmar, W. Nouira, S. Maatouk, S.B. Youssef, F. Dachraoui et al. Early Variation of ROX Index Predicts High-Flow Nasal Cannula Outcome in Awake Subjects With Severe Hypoxemic COVID-19. Respiratory Care. 2023; 68(1):110-113.
[37] H.M.R. Karim, A. Bharadwaj, O.M. Mujahid, M.P. Borthakur, C.K. Panda, J.V. Kalbande. The Relationship of Respiratory Rate-Oxygenation (ROX) and Modified ROX Index With High-Flow Nasal Cannula Oxygen Therapy in COVID-19 Patients: An Observational Pilot Study. Cureus Journal of Medical Science. 2022; 14(12):e32900.
[38] A. Kansal, W.J.D. Ong, S. Dhanvijay, A.T.P. Siosana, L.M. Padillo, C.K. Tan, M. Gulati Kansal et al. Comparison of ROX index (SpO(2)/FIO(2) ratio/respiratory rate) with a modified dynamic index incorporating PaO(2)/FIO(2) ratio and heart rate to predict high flow nasal cannula outcomes among patients with acute respiratory failure: a single centre retrospective study. BMC Pulmonary Medicine. 2022; 22(1):350.
[39] M. Ibarra-Estrada, M.J. Gamero-Rodríguez, M. García-de-Acilu, O. Roca, L. Sandoval-Plascencia, G. Aguirre-Avalos, R. García-Salcido et al. Lung ultrasound response to awake prone positioning predicts the need for intubation in patients with COVID-19 induced acute hypoxemic respiratory failure: an observational study. Critical care (London, England). 2022; 26(1):189.
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