Asian Oncol Nurs.  2023 Dec;23(4):185-195. 10.5388/aon.2023.23.4.185.

Factors Influencing the Success of High-flow Nasal Cannula Treatment Applied to Respiratory Distress Patients with Hematologic Neoplasms

• Kim EH
• Kim DY
• Yoo YS

• KMID: 2550442
• DOI: http://doi.org/10.5388/aon.2023.23.4.185

Abstract

Purpose
This study aimed to evaluate the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict the success for high-flow nasal cannula (HFNC) treatment applied to patients with hematologic neoplasms.
Methods
A total of 167 patients who were admitted to the hematology intensive care unit were included in this study. Data were collected from electronic nursing records and were analyzed using the χ² test, independent t-test, Mann-Whitney U test, logistic regression, Receiver Operating Characteristic curve, and Area Under the Curve (AUC).
Results
Eighty-nine (53.3%) patients were successfully weaned from HFNC, while 78 (46.7%) were unsuccessful. Considering specificity and sensitivity, the optimal cut-off points for predicting the success and failure of HFNC oxygen therapy were 4.50 and 14.16 (ROX index), 3.78 and 15.05 (ROX-HR index), and 119.95 and 278.06 (SF ratio), respectively. Time measurement showed that the most significant AUC was recorded before HFNC interruption occurred.
Conclusion
Nurses caring for critically ill patients with hematologic neoplasms should closely observe and periodically check patients’ breathing patterns. It is crucial to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

Keyword

Heart rate; Hematologic neoplasms; Intensive care units; Oxygen saturation; Respiratory insufficiency