{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:58:42Z","timestamp":1785776322231,"version":"3.56.0"},"reference-count":56,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["10430102110007"],"award-info":[{"award-number":["10430102110007"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>High\u2010Flow Nasal Oxygen (HFNO) can reduce the need for invasive mechanical ventilation in patients with acute hypoxemic respiratory failure (AHRF) from viral pneumonias, like COVID\u201019. Early prediction of HFNO failure is useful for timely decision\u2010making at HFNO initiation. This study aimed to develop a prediction model for HFNO failure using predictors available just prior to HFNO initiation in patients with COVID\u201019 AHRF and compare its performance to existing models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter, prospective observational cohort study included hospitalized patients from 10 centers in the Netherlands between December 2020 and July 2021. Adults who tested positive for SARS\u2010CoV\u20102, had no treatment limitations, and initiated HFNO for hypoxemia were included. The primary outcome was HFNO failure, defined as the event of endotracheal intubation. Pre\u2010defined candidate predictors were selected by multivariable logistic regression for prediction model development. Internal validation was conducted using bootstrapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 608 patients, 277 (46%) experienced HFNO failure. Independent predictors of HFNO failure included (odds ratio [95% CI]): age (1.02 [1.00\u20131.03]), urea (1.04 [1.00\u20131.08]), platelet count (0.94 [0.92\u20130.97]), respiratory rate (1.05 [1.02\u20131.08]), oxygen saturation (0.89 [0.84\u20130.94]), and FiO\n                      <jats:sub>2<\/jats:sub>\n                      (conventional oxygen 10\u201315\u2009L\/min vs. &lt;\u200910\u2009L\/min: 3.00 [1.71\u20135.29], 15\u2009L\/min vs. &lt;\u200910\u2009L\/min: 4.95 [3.19\u20137.70]) prior to HFNO initiation. The model C\u2010statistic was 0.767; 95% CI [0.727\u20130.803], with excellent calibration (intercept: \u22120.005, slope: 1.001), and stable performance after internal validation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This newly developed model, using variables available at HFNO initiation, effectively predicted HFNO failure in hospitalized hypoxemic patients due to COVID\u201019 pneumonia with good performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration Number Clinical Trial<\/jats:title>\n                    <jats:p>\n                      Dutch Trial Registry: DTR, NL9067.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70254-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/resp.70254","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T04:39:08Z","timestamp":1776227948000},"page":"798-807","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting Failure at Initiation of High\u2010Flow Nasal Oxygen in Patients With\n                    <scp>COVID<\/scp>\n                    \u201019: Literature Review, Development and Internal Validation of a Prediction Model"],"prefix":"10.1002","volume":"31","author":[{"given":"Daphne J. T.","family":"Sjauw","sequence":"first","affiliation":[{"name":"Department of Intensive Care Franciscus Gasthuis &amp; Vlietland  Rotterdam the Netherlands"},{"name":"Department of Intensive Care Erasmus Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs L.","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Franciscus Gasthuis &amp; Vlietland  Rotterdam the Netherlands"},{"name":"Department of Intensive Care Erasmus Medical Center  Rotterdam the Netherlands"},{"name":"Department of Respiratory Medicine Erasmus Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasemin","family":"T\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Franciscus Gasthuis &amp; Vlietland  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen A. T.","family":"Reep","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Erasmus Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Heunks","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara J.","family":"Baart","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Erasmus Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2868-0920","authenticated-orcid":false,"given":"Evert\u2010Jan","family":"Wils","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Franciscus Gasthuis &amp; Vlietland  Rotterdam the Netherlands"},{"name":"Department of Intensive Care Erasmus Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Dutch HFNO study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"NORMO2 project group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005963"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.15613"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010067879"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.20714"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.0028"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.04.022"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201605\u20101081CP"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010015\u20103693\u20105"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010020\u201000692\u20106"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000329"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pulmoe.2021.10.001"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60010071"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/life11080735"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2589\u20107500(20)30316\u20102"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560\u2010021\u201000538\u20108"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10204751"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.607821"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000006068"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102023\u2010078378"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl\u20102020\u2010214863"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m441"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470316696"},{"issue":"4","key":"e_1_2_11_25_1","first-page":"361","article-title":"Multivariable Prognostic Models: Issues in Developing Models, Evaluating Assumptions and Adequacy","volume":"15","author":"Harrell J. F. E. L. K.","year":"1996","journal-title":"Biostatistics"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X0900900101"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2023.154443"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201803\u20100589OC"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2016.05.022"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010016\u20104601\u20103"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560\u2010024\u201000720\u20108"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201002078\u20105"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2021.08.012"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2023.10.013"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/v15112231"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.58311"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890\u2010022\u201002121\u20109"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1159\/000540004"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.29390\/cjrt-2022-005"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30566\u20103"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102020\u20100369"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3339"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6775"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010020\u20102521\u20104"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010020\u201005991\u2010z"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14\u20100698"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(21)00442\u20103"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b375"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201904\u20100841OC"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202204\u20100629OC"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010024\u201001367\u20102"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010025\u201005730\u2010y"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010020\u201003176\u2010y"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010025\u201005526\u20100"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.007593"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.04.007"}],"container-title":["Respirology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/resp.70254","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/resp.70254","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/resp.70254","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:34:48Z","timestamp":1785774888000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/resp.70254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":56,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/resp.70254"],"URL":"https:\/\/doi.org\/10.1002\/resp.70254","archive":["Portico"],"relation":{},"ISSN":["1323-7799","1440-1843"],"issn-type":[{"value":"1323-7799","type":"print"},{"value":"1440-1843","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]},"assertion":[{"value":"2025-09-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}