{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:02:35Z","timestamp":1781719355240,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>High\u2010flow nasal cannula (HFNC) is commonly used as first step respiratory support in infants with moderate\u2010to\u2010severe acute viral bronchiolitis (AVB). This device, however, fails to effectively manage respiratory distress in about a third of patients, and data are limited on determinants of patient response. The respiratory rate\u2013oxygenation (ROX) index is a relevant tool to predict the risk for HFNC failure in adult patients with lower respiratory tract infections. The primary objective of this study was to assess the relationship between ROX indexes collected before and 1\u2009h after HFNC initiation, and HFNC failure occurring in the following 48\u2009h in infants with AVB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This is an ancillary study to the multicenter randomized controlled trial TRAMONTANE 2, that included 286 infants of less than 6 months with moderate\u2010to\u2010severe AVB. Collection of physiological variables at baseline (H0), and 1\u2009h after HFNC (H1), included heart rate (HR), respiratory rate (RR), fraction of inspired oxygen (FiO<jats:sub>2<\/jats:sub>), respiratory distress score (modified Wood's Clinical Asthma Score [mWCAS]), and pain and discomfort scale (EDIN). ROX and ROX\u2010HR were calculated as  and , respectively. Predefined HFNC failure criteria included increase in respiratory distress score or RR, increase in discomfort, and severe apnea episodes. The accuracies of ROX, ROX\u2010HR indexes and clinical variable to predict HFNC failure were assessed using receiver operating curve analysis. We analyzed predictive factors of HFNC failure using multivariate logistic regressions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>HFNC failure occurred in 111 of 286 (39%) infants, and for 56 (50% of the failure) of them within the first 6\u2009h. The area under the curve of ROX indexes at H0 and H1 were, respectively, 0.56 (95% confidence interval [CI] 0.48\u20130.63, <jats:italic>p<\/jats:italic>\u2009=\u20090.14), 0.56 (95% CI 0.49\u20130.64, <jats:italic>p<\/jats:italic>\u2009=\u20090.09). ROX\u2010HR performances were better but remained poorly discriminant. HFNC failure was associated with higher mWCAS score at H1 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and lower decrease in EDIN scale during the first hour of HFNC delivery (<jats:italic>p<\/jats:italic>\u2009=\u20090.02). In the multivariate analyses, age and mWCAS score were were found to be independent factors associated with HFNC failure at H0. At H1, weight and mWCAS were associated factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, neither ROX index, nor physiological variables usually collected in infants with AVB had early discriminatory capacity to predict HFNC failure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26860","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T11:58:36Z","timestamp":1704887916000},"page":"982-990","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["ROX (Respiratory rate\u2013OXygenation) index to predict early response to high\u2010flow nasal cannula therapy in infants with viral bronchiolitis"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7714-5054","authenticated-orcid":false,"given":"Christophe","family":"Milesi","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care Unit Arnaud de Villeneuve University Hospital Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Nogue","sequence":"additional","affiliation":[{"name":"Clinical Research and Epidemiology Unit, CHU Montpellier Univ Montpellier Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Baleine","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Arnaud de Villeneuve University Hospital Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7873-3245","authenticated-orcid":false,"given":"Lionel","family":"Moulis","sequence":"additional","affiliation":[{"name":"Clinical Research and Epidemiology Unit, CHU Montpellier Univ Montpellier Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Pouyau","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Woman\u2010Mother\u2010Child University Hospital Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6485-7634","authenticated-orcid":false,"given":"Arthur","family":"Gavotto","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Arnaud de Villeneuve University Hospital Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2059-9888","authenticated-orcid":false,"given":"David","family":"Brossier","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit University Hospital Caen\u2010Normandy  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2145-5330","authenticated-orcid":false,"given":"Guillaume","family":"Mortamet","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Grenoble University Hospital La Tronche France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1360-7915","authenticated-orcid":false,"given":"Gilles","family":"Cambonie","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Arnaud de Villeneuve University Hospital Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"GFRUP Respiratory Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2021.5177"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-022-06918-4"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2879-y"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23060"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.06.006"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30061-2"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4617-8"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1714855"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25033"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2019.07.007"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2018.10.001"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0444"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2017-0034"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e31829e7f2f"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23626"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23981"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/pxy123"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.12.017"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2016.05.022"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201803-0589OC"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2021.08.012"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-020-03847-6"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-022-04607-4"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5343-1"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09765"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-008-1201-x"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26860","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T12:37:04Z","timestamp":1712925424000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.26860"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,10]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/ppul.26860"],"URL":"https:\/\/doi.org\/10.1002\/ppul.26860","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,10]]},"assertion":[{"value":"2023-08-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}