Predicting High-Flow Nasal Cannula Failure Using an Electrical Impedance Tomography-Derived Index: A Multicenter Study
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About
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.
Full 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.
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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
Trial design
90 participants in 1 patient group
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Data sourced from clinicaltrials.gov
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