The aim of this prospective observational cohort study is to develop a predictive modelfor high-flow nasal cannula (HFNC) failure in patients with acute hypoxemic respiratoryfailure (AHRF) caused by SARS-CoV-2. By combining clinical data and metabolomic profiles,the study seeks to answer:- Can integrating clinical parameters with metabolomic markers enhance the prediction ofHFNC failure in AHRF patients?Participants with AHRF due to SARS-CoV-2 receiving HFNC under standard-of-care protocolswill be monitored until hospital discharge or death. Blood samples for metabolomicanalysis will be collected at inclusion.
This prospective observational cohort study focuses on developing and validating a
predictive model for HFNC failure in patients with SARS-CoV-2-related AHRF, combining
clinical parameters and metabolomic profiling. Patients received standard-of-care therapy
based on hospital protocols, with clinical data and plasma samples collected at inclusion
(T0) for laboratory and metabolomic analyses.
The study consists of two cohorts: a Training Cohort (March 2020 to April 2021) for model
development and a Validation Cohort (May 2021 to October 2021) for model validation and
external testing. HFNC outcomes were classified as success or failure, with failure
defined as requiring orotracheal intubation (OTI). Advanced machine-learning techniques
were employed for feature selection and model optimization, targeting precise integration
of clinical and metabolomic data.
This model seeks to enhance early identification of HFNC failure risk, enabling timely
interventions and personalized management in critically ill AHRF patients.
Inclusion Criteria:
- Adult patients (≥18 years old) with acute hypoxemic respiratory failure (AHRF)
confirmed as secondary to SARS-CoV-2 infection via PCR testing.
- Requirement for high-flow nasal cannula (HFNC) initiated within 48 hours of hospital
admission.
Exclusion Criteria:
- Patients under the age of 18
- Patients with active "do not resuscitate" (DNR) orders at the time of inclusion.
Hospital del Mar
Barcelona 3128760, Spain, Spain