The following is a summary of “Development of clinical tools to estimate the breathing effort during high-flow oxygen therapy: A multicenter cohort study,” published in the May 2024 issue of Pulmonology by Protti et al.
Quantifying breathing effort in non-intubated patients is a critical yet challenging task, particularly for those undergoing high-flow oxygen therapy. This study aimed to develop two predictive models to estimate breathing effort in such patients.
The researchers analyzed data from 260 patients who received high-flow oxygen therapy in prior studies. Breathing effort was quantified by measuring the maximal deflection of esophageal pressure (ΔPes). Two predictive models were developed: a multivariable linear regression model to estimate ΔPes (in cmH2O) and a multivariable logistic regression model to predict the likelihood of ΔPes exceeding 10 cmH2O. Candidate predictors included age, sex, COVID-19 diagnosis, respiratory rate, heart rate, mean arterial pressure, arterial blood gas analysis results (including base excess concentration, BEa), and the ratio of arterial oxygen tension to inspiratory oxygen fraction (PaO2). Additionally, the interaction between COVID-19 status and PaO2 was considered.
The linear regression model identified significant predictors of ΔPes, including COVID-19 status, BEa, respiratory rate, PaO2 ratio, and the interaction between COVID-19 status and PaO2 ratio. The adjusted R2 for this model was 0.39, indicating a moderate level of predictive accuracy. The logistic regression model identified BEa, respiratory rate, and PaO2
ratio as significant predictors of a ΔPes greater than 10 cmH2O, with an area under the receiver operating characteristic curve of 0.79 (95% CI: 0.73–0.85), demonstrating good discriminatory ability. These two models were collectively termed BREF, an acronym derived from BReathing EFfort, incorporating the three common predictors: BEa (B), respiratory rate (RE), and PaO2(F).
The study group successfully developed two predictive models, BREF, to estimate the breathing effort in patients receiving high-flow oxygen therapy. The initial findings indicate that these models are promising tools for clinical assessment and warrant further validation. This study underscores the potential of using a combination of clinical and physiological parameters to enhance the management of respiratory support in patients who are critically ill.
Source: sciencedirect.com/science/article/pii/S2531043724000540
The post BREF Models Successfully Estimate Breathing Effort in Patients Receiving High-Flow Oxygen Therapy first appeared on Physician's Weekly.