{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T10:49:39Z","timestamp":1775472579929,"version":"3.50.1"},"reference-count":23,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Several studies have suggested that high-flow nasal cannula (HFNC) is useful for respiratory support after extubation in subjects with COVID-19 pneumonia, whereas 18% subsequently needed to undergo re-intubation. This study aimed to evaluate whether the breathing frequency (f)-ratio of oxygen saturation (ROX) index, which has been shown to be useful for predicting future intubation, is also useful for re-intubation in subjects with COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed mechanically ventilated subjects with COVID-19 who underwent HFNC therapy after extubation at 4 participating hospitals between January 2020\u2013May 2022. We evaluated the predictive accuracy of ROX at 0, 1, and 2 h for re-intubation until ICU discharge and compared the area under the receiver operating characteristic (ROC) curve of the ROX index with those of f and S\n                      <jats:sub>\n                        pO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      \/F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among the 248 subjects with COVID-19 pneumonia, 44 who underwent HFNC therapy after extubation were included. A total of 32 subjects without re-intubation were classified into the HFNC success group, and 12 with re-intubation were classified into the failure group. The overall trend that the area under the ROC curve of the ROX index was greater than that of the f and S\n                      <jats:sub>\n                        aO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      \/F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      was observed, although there was no statistical significance at any time point. The ROX index at 0 h, at the cutoff point of &lt; 7.44, showed a sensitivity and specificity of 0.42 and 0.97, respectively. A trend of positive correlation between the time until re-intubation and ROX index at each time point was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The ROX index in the early phase of HFNC therapy after extubation was useful for predicting re-intubation with high accuracy in mechanically ventilated subjects with COVID-19. Close observation for patients with &lt; 7.44 ROX index just after extubation may be warranted because of their high risk for re-intubation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.10549","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T14:30:12Z","timestamp":1684247412000},"page":"1067-1074","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictive Accuracy of the ROX Index for Re-Intubation in Mechanically Ventilated Patients With COVID-19"],"prefix":"10.1177","volume":"68","author":[{"given":"Yusuke","family":"Okazaki","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University. Hiroshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuaki","family":"Nishikimi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University. Hiroshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junki","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University. Hiroshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University. Hiroshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichiro","family":"Ohshimo","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University. Hiroshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuaki","family":"Shime","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University. Hiroshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/08850666211020281"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.14194"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.5114\/ait.2020.101007"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-92960-z"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0251030"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3693-5"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1590\/1518-8345.4732.3397"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2016.05.022"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.08564"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201803-0589OC"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2021.106638"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-020-01354-w"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2021.08.012"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-017-0222-3"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.1.ats1000"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02426-2016"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00010206"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2006.00178.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181ec173d"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.08631"},{"key":"e_1_3_2_22_2","first-page":"S136","article-title":"Outcomes and risk factors of extubation failure: a multi-center study of the THAI surgical intensive care units (SICUs)","volume":"99","author":"Buppha P","year":"2016","unstructured":"Buppha P, , Kusumaphanyo C, , Chittawatanarat K. Outcomes and risk factors of extubation failure: a multi-center study of the THAI surgical intensive care units (SICUs). 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