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SpO 2/FiO 2 as a predictor of high flow nasal cannula outcomes in children with acute hypoxemic respiratory failure

 Ga Eun Kim  ;  Sun Ha Choi  ;  Mireu Park  ;  Jae Hwa Jung  ;  Myeongjee Lee  ;  Soo Yeon Kim  ;  Min Jung Kim  ;  Yoon Hee Kim  ;  Kyung Won Kim  ;  Myung Hyun Sohn 
 SCIENTIFIC REPORTS, Vol.11(1) : 13439, 2021-06 
Journal Title
Issue Date
The high-flow nasal cannula (HFNC) is a useful treatment modality for acute hypoxemic respiratory failure (AHRF) in children. We compared the ability of the oxygen saturation to fraction of inspired oxygen ratio (S/F) and arterial oxygen partial pressure to fraction of inspired oxygen ratio (P/F) to predict HFNC outcomes in children with AHRF. This study included children treated with HFNC due to AHRF from April 2013 to March 2019 at the Severance Children's Hospital. HFNC failure was defined as the need for mechanical ventilation. Trends of S/F and P/F during HFNC were analyzed. To predict HFNC outcomes, a nomogram was constructed based on predictive factors. A total of 139 patients with arterial blood gas data were included in the S/F and P/F analyses. S/F < 230 at initiation showed high prediction accuracy for HFNC failure (area under the receiver operating characteristic curve: 0.751). Univariate analyses identified S/F < 230 at HFNC initiation and < 200 at 2 h (odds ratio [OR] 12.83, 95% CI 5.06-35.84), and hemato-oncologic disease (OR 3.79, 95% CI 1.12-12.78) as significant predictive factors of HFNC failure. The constructed nomogram had a highly predictive performance, with a concordance index of 0.765 and 0.831 for the exploratory and validation groups, respectively. S/F may be used as a predictor of HFNC outcomes. Our nomogram with S/F for HFNC failure within 2 h may prevent delayed intubation in children with AHRF.
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1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0002-5634-9709
Kim, Soo Yeon(김수연) ORCID logo https://orcid.org/0000-0003-4965-6193
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Park, Mireu(박미르)
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
Lee, Myeongjee(이명지)
Jung, Jae Hwa(정재화)
Choi, Sun Ha(최선하)
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