Heart & lung : the journal of critical care · 2025
Volume OXygenation index in predicting the efficacy of early non-invasive ventilation in patients with acute hypoxic respiratory failure: A multicenter study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Liu Xiaoyi, Liu Hui, Chen Lijuan, Duan Jun, Ran Hui, Chen Lili, Zhou Rui, Zheng Xiangde
Аннотация
BACKGROUND: The Volume OXygenation (VOX) index was initially designed to predict treatment failure of high-flow nasal cannula therapy. However, its predictive power for non-invasive ventilation (NIV) remains uncertain.
OBJECTIVES: To evaluate the predictive capability of the VOX index regarding treatment failure in patients undergoing NIV.
METHODS: This retrospective study was conducted in three hospitals from September 2017 to September 2021. Patients with acute hypoxic respiratory failure (AHRF) who underwent early NIV treatment were categorized into high-risk and low-risk groups based on the 2-hour NIV VOX Youden index.
RESULTS: At 2 h of NIV, the area under the receiver operating characteristic curve for predicting NIV failure using the VOX index was 0.843 (95 % CI 0.805-0.882). Using a VOX value threshold of 20.45 to predict NIV failure, the sensitivity was 69.1 %, and the specificity was 94.4 %. Following NIV treatment, the low-risk group had a lower intubation rate (7.98 % vs. 77 %, P < 0.05) and mortality rate (4.79 % vs. 17.5 %, P < 0.05).
CONCLUSION: In early NIV treatment for AHRF, the VOX index obtained after 2 h of NIV demonstrates a strong predictive power for NIV failure. Patients with a VOX value > 20.45 have a low probability of NIV failure, suggesting that it can be used as an evaluation index to assess the efficacy of NIV.
OBJECTIVES: To evaluate the predictive capability of the VOX index regarding treatment failure in patients undergoing NIV.
METHODS: This retrospective study was conducted in three hospitals from September 2017 to September 2021. Patients with acute hypoxic respiratory failure (AHRF) who underwent early NIV treatment were categorized into high-risk and low-risk groups based on the 2-hour NIV VOX Youden index.
RESULTS: At 2 h of NIV, the area under the receiver operating characteristic curve for predicting NIV failure using the VOX index was 0.843 (95 % CI 0.805-0.882). Using a VOX value threshold of 20.45 to predict NIV failure, the sensitivity was 69.1 %, and the specificity was 94.4 %. Following NIV treatment, the low-risk group had a lower intubation rate (7.98 % vs. 77 %, P < 0.05) and mortality rate (4.79 % vs. 17.5 %, P < 0.05).
CONCLUSION: In early NIV treatment for AHRF, the VOX index obtained after 2 h of NIV demonstrates a strong predictive power for NIV failure. Patients with a VOX value > 20.45 have a low probability of NIV failure, suggesting that it can be used as an evaluation index to assess the efficacy of NIV.