{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T05:13:38Z","timestamp":1771046018473,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"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":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study evaluates the ROX index's accuracy in predicting the success or failure of high\u2010flow nasal cannula (HFNC) therapy in children under 2 years with acute respiratory failure (ARF) from lower respiratory tract infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From January 2018 to 2021 we conducted this multicenter retrospective cohort study, which included patients aged 2\u201324 months. We aimed to assess HFNC therapy outcomes as either success or failure. The analysis covered patient demographics, diagnoses, vital signs, and ROX index values at intervals from 0 to 48 h after initiating HFNC. We used bivariate analysis, repeated measures ANOVA, multivariate logistic regression, and the area under the receiver operating characteristic (AUC\u2010ROC) curve for statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study involved 529 patients from six centers, with 198 females (37%) and a median age of 9 months (IQR: 3\u201315 months). HFNC therapy failed in 38% of cases. We observed significant variability in failure rates across different centers and physicians (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The ROX index was significantly associated with HFNC outcomes at all time points, showing an increasing trend in success cases over time (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), but not in HFNC failure cases. Its predictive ability is limited, with AUC\u2010ROC values ranging from 0.56 at the start to 0.67 at 48 h.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While the ROX index is associated with HFNC outcomes in children under 2 years, its predictive ability is modest, impacted by significant variability among patients, physicians, and centers. These findings emphasize the need for more reliable predictive tools for HFNC therapy in this patient population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26895","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T10:18:11Z","timestamp":1706869091000},"page":"1246-1255","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Can the ROX index predict high\u2010flow nasal cannula failure in children under 2 with lower respiratory tract infection?"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4892-5032","authenticated-orcid":false,"given":"Pablo","family":"Vasquez\u2010Hoyos","sequence":"first","affiliation":[{"name":"Department of Pediatrics Universidad Nacional de Colombia Bogota Colombia"},{"name":"Sociedad de Cirug\u00eda de Bogota Hospital de San Jose Bogota Colombia"},{"name":"Department of Pediatrics Fundacion Universitaria de Ciencias de la 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