Revisión sistemática de la efectividad pronóstica del índice ROX como predictor de falla terapéutica con cánula nasal de alto flujo (CNAF) en pacientes con neumonía por COVID-19

Abstract

Background: Acute Respiratory Distress Syndrome (ARDS) generated by the SARS-CoV-2 virus (COVID-19) is an emerging pathology that has caused worldwide challenges for the diagnosis, follow-up, treatment and management of associated complications. In the literature, there are few scales for predicting clinical severity and therapeutic failure in this context, so the use of the ROX index has been used and validated during this pandemic as a predictor of therapeutic failure with a high-flow nasal cannula (HFNC). Methodology: This is quantitative research with a retrospective and descriptive approach. A systematic review of the literature was carried out in the main databases within the medical literature to evaluate the efficacy of the ROX index as a predictor of therapeutic failure with HHFNC based on the interpretation of statistical values. MeSH terms ( ROX, index, COVID-19) were used to standardize the search terms, and inclusion and exclusion criteria were applied to select the studies to be analyzed. Results: In general, the groups that presented therapeutic failure with CNAF therapy had, on average, lower ROX index values than the successful group and, for the most part, lower average age and lower prevalence of arterial hypertension and diabetes mellitus. The heterogeneity, the methodological characteristics of the study and the risk of confounding bias made it impossible to perform other analyses initially considered significant and of high scientific value for the problem in question. Conclusions: To evaluate the diagnostic effectiveness of the ROX index as a predictor of therapeutic failure to CNAF therapy in patients with critical illness of pulmonary etiology by COVID-19, studies with similar methodological characteristics are required. Standardization of measurement times and cut-off points is considered essential to reduce heterogeneity between studies and thus facilitate the analysis of the statistical validity of the ROX index.