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Health promotion and disease prevention

Vol. 28 No. 2 (2026)

Oxygenation indices as predictors of respiratory failure treated with high-flow nasal cannula versus non-invasive mechanical ventilation. Systematic review

DOI
https://doi.org/10.22267/rus.262802.9591
Submitted
June 17, 2025
Published
2026-05-01

Abstract

Introduction: Oxygenation indices are used to assess oxygenation and guide therapeutic management with high-flow nasal cannula therapy and/or noninvasive mechanical ventilation in adult intensive care units.

Objective: To evaluate oxygenation indices as predictors of mortality, oxygenation, intubation, extubation, and ventilatory support in adult intensive care patients with respiratory failure receiving high-flow nasal cannula therapy versus noninvasive mechanical ventilation.

Materials and Methods: A systematic literature review was conducted; 289 studies were selected, and 20 studies were reviewed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Quality Assessment of Case-Control Studies by four blinded reviewers.

Results: Oxygenation indices confirmed the diagnosis of respiratory failure, with improvements in arterial pressure and oxygen saturation. The Kirby index improved significantly with high-flow nasal cannula, a form of support that is better tolerated and has a lower reintubation rate. The use of noninvasive mechanical ventilation was associated with a higher risk of mortality.

Conclusions: Oxygenation indices are critical predictors in acute respiratory failure, and their systematic monitoring optimizes therapeutic decision-making and improves the prognosis for survival.

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