ROX Index to Predict Risk of Intubation
Predict risk of intubation at 2, 6 and 12 hours in hypoxemic respiratory failure. Not yet validated for COVID-19
SpO₂ represents peripheral capillary oxygen saturation
FiO₂ is the % concentration of oxygen that a person inhales, the fraction of inspired oxygen. Atmospheric air has a typical FiO₂ 21%.
During high-flow nasal cannula (HFNC) therapy in patients with acute hypoxemic respiratory failure, it can be desirable not to delay intubation and have an adverse event.
The ROX index, defined as the ratio of oxygen saturation as measured by pulse oximetry/FIO2 to respiratory rate, has been assessed as a predictor of the need to intubate in patients received HFNC oxygen therapy.
Prediction accuracy of the ROX index increased over time with AUC of 0.679 at 2 h, 0.703 at 6 hours and 0.759 at 12 hours.
ROX &ge:4.88 at 2, 6 and 12 hours after HFNC initiation was associated with a lower risk for intubation.
Predictors of HFNC failure include:
- ROX <:2.85 at 2 hours
- ROX <:3.47 at 6 hours
- ROX <:3.85 at 12 hours
- [1]Roca O 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 June 1, 199 (11): 1368-1376.
Results
Real-time automated computation
During high-flow nasal cannula (HFNC) therapy in patients with acute hypoxemic respiratory failure, it can be desirable not to delay intubation and have an adverse event.
The ROX index, defined as the ratio of oxygen saturation as measured by pulse oximetry/FIO2 to respiratory rate, has been assessed as a predictor of the need to intubate in patients received HFNC oxygen therapy.
Prediction accuracy of the ROX index increased over time with AUC of 0.679 at 2 h, 0.703 at 6 hours and 0.759 at 12 hours.
ROX &ge:4.88 at 2, 6 and 12 hours after HFNC initiation was associated with a lower risk for intubation.
Predictors of HFNC failure include:
- ROX <:2.85 at 2 hours
- ROX <:3.47 at 6 hours
- ROX <:3.85 at 12 hours
- [1]Roca O 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 June 1, 199 (11): 1368-1376.