{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:58:25Z","timestamp":1782925105106,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Volume OXygenation (VOX) index has good efficacy in predicting the failure of high\u2010flow nasal cannula therapy. However, its predictive value for treatment failure in patients receiving noninvasive ventilation (NIV) remains uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent early NIV treatment were grouped based on their 2\u2010h NIV VOX Youden index. The low\u2010risk group consisted of patients with a VOX value &gt; 20.45 (<jats:italic>n<\/jats:italic>\u2009=\u2009188), while the high\u2010risk group included those with a VOX value \u2264 20.45 (<jats:italic>n<\/jats:italic>\u2009=\u2009200). Baseline data and arterial blood gas values were collected at 2, 12, and 24\u2009h after NIV initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to the low\u2010risk group, the high\u2010risk group exhibited higher SOFA scores, respiratory rates, and heart rates, along with a lower oxygenation index (P\/F) (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Following NIV treatment, the low\u2010risk group showed a more significant increase in P\/F values at 2\u2009h, 12\u2009h, and 24\u2009h after NIV initiation. The low\u2010risk group showed a lower VT and MV (minute ventilation volume) at 2\u2009h, 12\u2009h, and 24\u2009h of NIV (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Moreover, the low\u2010risk group had a lower intubation rate (7.98% vs. 77%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and mortality rate (4.79% vs. 17.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). At 2\u2009h of NIV, the area under the receiver operating characteristic curve for predicting NIV failure using the VOX index was 0.843 (95% CI 0.805\u20130.882). Using a VOX value threshold of 20.45 to predict NIV failure, the sensitivity was 69.1%, and the specificity was 94.4%. Furthermore, a VOX value \u2264 20.45 was identified as an independent risk factor for tracheal intubation and death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>VOX index shows promise to serve as an effective evaluation index to predict early NIV efficacy in patients with AHRF; a VOX value &gt; 20.45 after 2\u2009h of NIV treatment can better predict improvements in hypoxia, respiratory drive, and NIV outcomes, guide early tracheal intubation in cases of NIV failure, and have a certain predictive effect on patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.70098","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T23:23:37Z","timestamp":1751325817000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Multicenter Retrospective Study Predicting Early Noninvasive Ventilation Failure in Patients With Acute Hypoxic Respiratory Failure"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0834-7095","authenticated-orcid":false,"given":"Xiaoyi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine Dazhou Central Hospital  Dazhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Liu","sequence":"additional","affiliation":[{"name":"Ophthalmology Dazhou Central Hospital  Dazhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangde","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Dazhou Central Hospital  Dazhou Sichuan 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