Abstract

Objective: To determine the success rate and identify early predictors for the success of High-Flow Nasal Cannula (HFNC) therapy in patients with acute hypoxemic respiratory failure in the Emergency Department of District 11 Hospital.

Methods: A prospective Interventional study was conducted on 93 patients with acute hypoxemic respiratory failure who received HFNC therapy from October 2024 to May 2025. Patients were monitored and outcomes were evaluated during their stay in the ED. Clinical data, ROX index, NEWS 2 score, and paraclinical data were collected. Multivariate logistic regression analysis was used to identify independent predictive factors.

Results: The overall success rate of HFNC therapy was 72.04%. Multivariate regression analysis showed that the ROX index at 30 minutes and 2 hours after initiation of HFNC, along with the NEWS 2 score at 2 hours, were independent predictors of success. Specifically, a ROX index at 30 minutes with a cutoff value > 5.472 had a sensitivity of 92.5%, while a ROX index at 2 hours with a cutoff value > 6.698 had a specificity of 88.5%. The mortality rate in the successful treatment group was significantly lower than in the failed group (8.96% vs. 61.54%, p < 0.001).

Conclusion: HFNC therapy has a high success rate and significantly improves the prognosis for survival in patients with acute hypoxemic respiratory failure in the ED. The ROX index and NEWS 2 score are useful clinical tools for predicting the success of this therapy, aiding in timely decision-making regarding the continuation or escalation of respiratory support.