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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versión impresa ISSN 2448-8909
Resumen
SALVADOR-IBARRA, Ibzan Jahzeel y PIZANA DAVILA, Alejandro. Prediction of failure of the high-flow nasal tips with the HACOR scale, in acute respiratory insufficiency in patients with SARS-CoV-2. Med. crít. (Col. Mex. Med. Crít.) [online]. 2021, vol.35, n.5, pp.250-255. Epub 23-Mayo-2022. ISSN 2448-8909. https://doi.org/10.35366/102353.
Acute hypoxemic respiratory failure (AHRF) is one of the main causes of admission to the intensive care unit in adult patients, around 40% of these patients require endotracheal intubation. The HACOR scale was designed and validated as a clinical prediction score for non-invasive ventilation (NIV) failure in patients with HAI of different etiologies.
Objective:
To analyze the predictive capacity of the HACOR scale in relation to the failure of the PNAF.
Material and methods:
A retrospective, observational study was carried out in the Intensive Care Unit at Hospital Ángeles Mocel, the PNAF was started when the patient had AHRF, the HACOR scale was calculated at one hour and 2 hours after the placement of the PNAF, the ability to predict HACOR scale PNAF failure was determined by calculating the area under the «receiver operating characteristic» (ROC) curve.
Results:
The HACOR scale with the highest discriminatory power was obtained 2 hours after the start of the PNAF with a cut-off point of 5 points with an area under the curve (AUC): 0.82 (CI 95% 0.67-0.98), it was obtained a sensitivity 84% CI 95% (56.6-89.9%), specificity 81% CI 95% (40.9-92.9%).
Conclusions:
A score greater than or equal to 5 points on the HACOR scale predicts failure of the PNAF and higher mortality with a sensitivity and specificity greater than 80% in patients with COVID-19 pneumonia.
Palabras llave : Acute respiratory failure; high-flow nasal tips; HACOR scale; success; failure; mechanical ventilation.
