Predicting High-Flow Nasal Cannula Failure Using an Electrical Impedance Tomography-Derived Index: A Multicenter Study
Overview
- Phase
- Not Applicable
- Status
- Active, not recruiting
- Sponsor
- Ruijin Hospital
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- HFNC Failure Rate
Overview
Brief Summary
High-Flow Nasal Cannula (HFNC) therapy is widely used to treat acute respiratory failure. However, predicting therapy failure remains challenging as conventional indices rely on intermittent measurements and cannot provide continuous, objective monitoring. Electrical Impedance Tomography (EIT) enables non-invasive, real-time assessment of regional lung ventilation. This study evaluated whether an EIT-derived Flow Index (FI) could predict HFNC therapy failure within 48 hours.
Detailed Description
Design: Single-center, prospective observational study. Setting: Ruijin Hospital, Shanghai, China. Population: Adult patients with acute respiratory failure receiving HFNC between December 2023 and March 2024. Intervention: EIT monitoring during spontaneous breathing while on HFNC. FI was calculated from EIT-derived regional ventilation signals using a curve-fitting formula quantifying inspiratory flow-time waveform concavity.
Endpoints: Primary - HFNC failure (escalation to mechanical ventilation or persistent hypoxemia within 48 h). ROC analysis compared FI with ROX index, respiratory rate, and SpO₂. Logistic regression models assessed predictive value and odds ratios.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to 90 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age ≥18 years
- •Acute respiratory failure requiring HFNC
- •Stable hemodynamics
- •FiO₂ ≤0.6
Exclusion Criteria
- •Neuromuscular disease affecting spontaneous breathing
- •Pregnancy
- •Contraindications to EIT
- •Poor EIT signal quality
Arms & Interventions
HFNC Oxygen Therapy
Intervention: Electrical impedance tomography(PulmoVista 500, Dräger Medical) (Device)
Outcomes
Primary Outcomes
HFNC Failure Rate
Time Frame: Within 48 hours of HFNC initiation
Secondary Outcomes
- ROC comparison of FI, ROX index, and conventional parameters(Within 48 hours)
- Odds ratio and confidence interval for FI predicting HFNC failure(Within 48 hours)