Aplicación del índice de ROX como predictor de fallo respiratorio en pacientes pediátricos con soporte de oxigenoterapia de alto flujo atendidos en el Hospital Roberto Gilbert Elizalde durante el período febrero – septiembre del 2023.

Abstract

Introduction: High-flow oxygen therapy is an ideal treatment for managing respiratory failure. It avoids orotracheal intubation; however, some patients are refractory to this treatment. The ROX Index aims to detect early failure in high-flow oxygen therapy; nevertheless, its use has been poorly studied in pediatrics. Objective: To evaluate the applicability of the ROX index as a tool to determine the failure of high-flow oxygen therapy in pediatric patients admitted to the Roberto Gilbert Hospital. Materials and Methods: Observational, prospective, longitudinal cohort study with a descriptive approach including patients between 1 month and 17 years old who required high-flow oxygen therapy within the first 24 hours. ROX index measurements were taken at 2, 4, 6, 12, and 24 hours with follow-up to determine the outcome. Results: A total of 209 patients meeting the inclusion criteria were obtained; 27 (12.9%) required endotracheal intubation (ETI), and 182 (87%) received high-flow oxygen therapy (HFNC). A higher frequency of younger infants was observed among patients who required ETI, with a median age of 12 months. A significant difference in the ROX index was found from two hours onwards with cutoff points on the AUROC curve above 0.5. Conclusions: It was determined that the ROX Index can be used as a complementary tool to strengthen decision-making in pediatrics.