rox_index v.1
The formula to calculate the prediction of high-flow nasal cannula failure, therefore the need for intubation.
The purpose is to describe early predictors and to develop a prediction tool that accurately identifies the need for mechanical ventilation (MV) in pneumonia patients with hypoxemic acute respiratory failure (ARF) treated with high-flow nasal cannula (HFNC).
After HFNC during reassessment, the ROX Index can help suggest which patients will fail HFNC and need to progress to intubation for further ventilatory support. While not externally validated, the ROX Index is a simple bedside calculation using three clinical variables and is one easy way to summarize a patient's degree of hypoxemic respiratory failure; it was created and studied to predict need for intubation post-HFNC, which is of particular importance in COVID-19. In patients with ARF and pneumonia, the ROX index can identify patients at low risk for HFNC failure in whom therapy can be continued after 12 hours.
One of the most challenging decisions in the management of ARF patients is to decide when to move from spontaneous breathing oxygenation therapy to invasive MV. Although HFNC may avoid further need for MV in some patients with ARF, it may unduly delay initiation of MV in others and worsen their outcome.
Roca O, Messika J, Caralt B, García-de-Acilu M, Sztrymf B, Ricard JD, Masclans JR. Predicting success of high-flow nasal cannula in pneumonia patients with hypoxemic respiratory failure: The utility of the ROX index. J Crit Care. 2016 Oct;35:200-5. doi: 10.1016/j.jcrc.2016.05.022. Epub 2016 May 31. PMID: 27481760.
openEHR-EHR-OBSERVATION.rox_index, openEHR-EHR-EVALUATION.rox_index
