目的:探讨儿童改良心率呼吸氧合指数对急性低氧性呼吸衰竭儿童经鼻高流量湿化氧疗失败的预测价值。方法:选取2018年1月—2023年12月厦门市儿童医院收治的符合急性呼吸衰竭诊断标准的经鼻高流量湿化氧疗(HFNC)患儿为研究对象。根据HFNC...目的:探讨儿童改良心率呼吸氧合指数对急性低氧性呼吸衰竭儿童经鼻高流量湿化氧疗失败的预测价值。方法:选取2018年1月—2023年12月厦门市儿童医院收治的符合急性呼吸衰竭诊断标准的经鼻高流量湿化氧疗(HFNC)患儿为研究对象。根据HFNC治疗是否成功分为HFNC成功组174例、HFNC失败组43例。观察两组HFNC治疗2 h、6 h、12 h、24 h改良心率-呼吸氧合指数(p-HR-ROX)之间的差异。采用受试者工作特征曲线(ROC曲线)分析p-ROX-HR预测HFNC治疗成败的价值,并求得截断值。结果:两组实验室指标比较,差异无统计学意义(P>0.05);两组血红蛋白、PaCO_(2)比较,差异有统计学意义(P<0.05)。两组2 h、6 h、12 h、24 h p-HR-ROX指数比较,差异有统计学意义(P<0.05);多因素结果分析提示12 h p-HR-ROX指数是HFNC治疗失败的独立保护因素,血红蛋白是HFNC治疗失败的独立保护因素。12 h p-HR-ROX指数的ROC曲线AUC值0.735(0.657,0.813),最佳截断值为31.79,曲线下面积为0.735。灵敏度为57.5%,特异度为86.7%。结论:应用p-HR-ROX指数可对HFNC治疗儿童急性低氧性呼吸衰竭的疗效进行预测。展开更多
Acute hypoxemic respiratory failure(AHRF)refers to“de novo”respiratory failure,excluding cardiogenic pulmonary edema or exacerbation of chronic lung diseases.AHRF can be defined as the arterial pressure of oxygen/in...Acute hypoxemic respiratory failure(AHRF)refers to“de novo”respiratory failure,excluding cardiogenic pulmonary edema or exacerbation of chronic lung diseases.AHRF can be defined as the arterial pressure of oxygen/inspiratory fraction of oxygen(PaO_(2)/FiO_(2))≤300 mmHg in patients receiving oxygen therapy.[1]Whereas FiO_(2)cannot be measured under a standard oxygen mask,it can be best estimated using the following formula:FiO_(2)(%)=flow of oxygen(L/min)×3+21%.[2]Several oxygenation strategies can be proposed as an alternative to standard oxygen in patients with AHRF,including highflow nasal cannula oxygen(HFNC),continuous positive airway pressure(CPAP),and noninvasive ventilation(NIV).展开更多
文摘目的:探讨儿童改良心率呼吸氧合指数对急性低氧性呼吸衰竭儿童经鼻高流量湿化氧疗失败的预测价值。方法:选取2018年1月—2023年12月厦门市儿童医院收治的符合急性呼吸衰竭诊断标准的经鼻高流量湿化氧疗(HFNC)患儿为研究对象。根据HFNC治疗是否成功分为HFNC成功组174例、HFNC失败组43例。观察两组HFNC治疗2 h、6 h、12 h、24 h改良心率-呼吸氧合指数(p-HR-ROX)之间的差异。采用受试者工作特征曲线(ROC曲线)分析p-ROX-HR预测HFNC治疗成败的价值,并求得截断值。结果:两组实验室指标比较,差异无统计学意义(P>0.05);两组血红蛋白、PaCO_(2)比较,差异有统计学意义(P<0.05)。两组2 h、6 h、12 h、24 h p-HR-ROX指数比较,差异有统计学意义(P<0.05);多因素结果分析提示12 h p-HR-ROX指数是HFNC治疗失败的独立保护因素,血红蛋白是HFNC治疗失败的独立保护因素。12 h p-HR-ROX指数的ROC曲线AUC值0.735(0.657,0.813),最佳截断值为31.79,曲线下面积为0.735。灵敏度为57.5%,特异度为86.7%。结论:应用p-HR-ROX指数可对HFNC治疗儿童急性低氧性呼吸衰竭的疗效进行预测。
文摘Acute hypoxemic respiratory failure(AHRF)refers to“de novo”respiratory failure,excluding cardiogenic pulmonary edema or exacerbation of chronic lung diseases.AHRF can be defined as the arterial pressure of oxygen/inspiratory fraction of oxygen(PaO_(2)/FiO_(2))≤300 mmHg in patients receiving oxygen therapy.[1]Whereas FiO_(2)cannot be measured under a standard oxygen mask,it can be best estimated using the following formula:FiO_(2)(%)=flow of oxygen(L/min)×3+21%.[2]Several oxygenation strategies can be proposed as an alternative to standard oxygen in patients with AHRF,including highflow nasal cannula oxygen(HFNC),continuous positive airway pressure(CPAP),and noninvasive ventilation(NIV).
