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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\u2019s 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\u2009&lt;\u2009230 at initiation showed high prediction accuracy for HFNC failure (area under the receiver operating characteristic curve: 0.751). Univariate analyses identified S\/F\u2009&lt;\u2009230 at HFNC initiation and\u2009&lt;\u2009200 at 2\u00a0h (odds ratio [OR] 12.83, 95% CI 5.06\u201335.84), and hemato-oncologic disease (OR 3.79, 95% CI 1.12\u201312.78) 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\u00a0h may prevent delayed intubation in children with AHRF.<\/jats:p>","DOI":"10.1038\/s41598-021-92893-7","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T10:06:39Z","timestamp":1624961199000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["SpO2\/FiO2 as a predictor of high flow nasal cannula outcomes in children with acute hypoxemic respiratory failure"],"prefix":"10.1038","volume":"11","author":[{"given":"Ga Eun","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Ha","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireu","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hwa","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myeongjee","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Yeon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Jung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon Hee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Won","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung Hyun","family":"Sohn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"issue":"324","key":"92893_CR1","first-page":"e329","volume":"27","author":"B Sztrymf","year":"2012","unstructured":"Sztrymf, B. et al. 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