What question did this study set out to answer?

The aim is to compare the efficacy of lung ultrasound scores and established clinical scoring systems in predicting non-invasive respiratory support outcomes in acute respiratory failure.

May 27, 2026Open Access

A prospective observational study comparing lung ultrasound and clinical scores ability in prediction of non invasive respiratory support outcome in acute respiratory failure

Key Points

The aim is to compare the efficacy of lung ultrasound scores and established clinical scoring systems in predicting non-invasive respiratory support outcomes in acute respiratory failure.
Prospective observational study with 82 patients suffering from type I and II acute respiratory failure.
Patients were treated with non-invasive ventilation (NIV) and high-flow nasal cannula (HFNC), and scores were assessed upon admission and after 48 hours.
Various scoring systems, including lung ultrasound score, ROX, HACOR, APACHE II, and the P/F ratio, were utilized for comparisons.
20 patients received NIV (16 succeeded, 4 failed) and 62 received HFNC (46 succeeded, 16 failed).
ROX index, HACOR score, APACHE II, and diaphragmatic thickening fraction predicted failure of NIRS effectively after 48 hours, along with the P/F ratio.
APACHE II score was the most accurate predictor when assessed on admission, while lung ultrasound score was not significant.

Abstract

Abstract Background Non-invasive oxygenation techniques lower the risk of ventilator-associated complications in cases of acute respiratory failure (ARF). Employing specific scoring systems derived from lung ultrasound (U/S) can predict failure of non-invasive respiratory support (NIRS), thereby reducing the use of mechanical ventilation (MV) and its associated complications. Objectives To assess the ability of different chest U/S scores to predict failure of NIRS methods in comparison with other scores, e.g., HACOR score, Acute Physiology and Chronic Health Evaluation (APACHE II), Respiratory rate–Oxygenation index (ROX), and the partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio. Methods Eighty-two patients presenting with ARF (type I and II) were managed with high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV). Routine laboratory tests were performed. Lung ultrasound score (LUS), diaphragmatic thickening fraction (DTF), ROX, HACOR, APACHE II, and PaO2/FiO2 ratio were calculated on admission and after 48 h. Results Among the 82 patients enrolled in this study, 20 (16 succeeded and 4 failed) were treated with NIV, and 62 (46 succeeded and 16 failed) were treated with HFNC. Comparisons between LUS, DTF, ROX, HACOR, APACHE II, and P/F ratio were performed. ROX index, HACOR score, APACHE II score, and DTF were able to predict failure of NIRS, and also predicted failure after 48 h of admission, in addition to the P/F ratio. Conclusion ROX index, P/F ratio, DTF, and APACHE II were able to predict failure of NIRS, with APACHE II being the most accurate on admission day. LUS was not significant.

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Cite This Study

Mohammed et al. (Mon,) studied this question.

synapsesocial.com/papers/6a168a9c0c924ddd1bd59482 https://doi.org/https://doi.org/10.1186/s43168-026-00583-7

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