Journal of Korean Academy of Nursing

Analysis of ROX Index, ROX-HR Index, and SpO 2 /FIO 2 Ratio in Patients Who Received HighFlow Nasal Cannula Oxygen Therapy in Pediatric Intensive Care Unit: Choi, Sun Hee , Kim, Dong Yeon , Song, Byung Yun , Yoo, Yang Sook; J Korean Acad Nurs 2023;53(4):468-479. Published online August 31, 2023; DOI: https://doi.org/10.4040/jkan.22152

Abstract PDF: Purpose
This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit.
Methods
A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ² test, Mann–Whitney U test, and area under the curve (AUC).
Results
Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption.
Conclusion
The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

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Characteristics of Aerobic Exercise as Determinants of Blood Pressure Control in Hypertensive Patients: A Systematic Review and Meta-Analysis: Lee, Sun Hee , Chae, Young Ran; J Korean Acad Nurs 2020;50(6):740-756. Published online December 31, 2020; DOI: https://doi.org/10.4040/jkan.20169

Abstract PDF: Purpose
The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis.
Methods
The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR.
Results
A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to –3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise.
Conclusion
Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.

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The Effects of Open Endotracheal Suctioning(ETS) and Close ETS on Oxygen Saturation and Heart Rate in Premature Infants with Respiratory Distress Syndrome: Mi Soon Kim, Young Mee Ahn, In Ok Park, Sook Ja Choi, Mi Young Yoo; Journal of Korean Academy of Nursing 1998;28(3):529-539. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.3.529

Abstract PDF: Prematurity is the main cause for respiratory distress syndrome(RDS) in neonates. The goal in the treatment of RDS is to maintain respiration with adequate oxygenation. ETS needs to be performed to remove lung secretions in the ventilated premature infants with RDS. Oxygen saturation(SpO2) and heart rate(HR) were compared in 22 premature infants with RDS using two types of ETS: open ETS versus close ETS. The results showed there was no significant difference in the SpO2 and HR returned to the baseline within 1 minute after suctioning. But in some case, there was a significantly greater incidence in the decrease of SpO2 below 90% occurred in the open ETS than in the close ETS. It implies that closed ETS may be beneficial to premature infants who tend to develop desaturation easily.

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Effect of Music Intervention on Maternal Anxiety and Fetal Heart Rate Pattern During Non-Stress Test: Myung Ok Oh, Young Jeoum Kim, Cho Hee Baek, Ju Hee Kim, No Mi Park, Mi Jeong Yu, Han Sol Song; J Korean Acad Nurs 2016;46(3):315-326. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.315

Abstract PDF: Purpose
The purpose of this cross-over experimental study was to examine effects of music intervention on maternal anxiety, fetal heart rate pattern and testing time during non-stress tests (NST) for antenatal fetal assessment.
Methods
Sixty pregnant women within 28 to 40 gestational weeks were randomly assigned to either the experimental group (n=30) or control group (n=30). Music intervention was provided to pregnant women in the experimental group during NST. Degree of maternal anxiety and fetal heart rate pattern were our primary outcomes. State-trait anxiety inventory, blood pressure, pulse rate, and changes in peripheral skin temperature were assessed to determine the degree of maternal anxiety. Baseline fetal heart rate, frequency of acceleration in fetal heart rate, fetal movement test and testing time for reactive NST were assessed to measure the fetal heart rate pattern.
Results
The experimental group showed significantly lower scores in state anxiety than the control group. There were no significant differences in systolic blood pressure and pulse rate between the two groups. Baseline fetal heart rate was significantly lower in the experimental group than in the control group. Frequency of acceleration in fetal heart rate was significantly increased in the experimental group compared to the control group. There were no significant differences in fetal movement and testing time for reactive NST between the two groups.
Conclusion
Present results suggest that music intervention could be an effective nursing intervention for alel viating anxiety during non-stress test.

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The Effects of Pneumoperitoneum on Heart Rate, Mean Arterial Blood Pressure and Cardiac Output of Hypertensive Patients during Laparoscopic Colectomy: Eun Ju Kim, Haesang Yoon; J Korean Acad Nurs 2010;40(3):433-441. Published online June 30, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.3.433

Abstract PDF: Purpose
This study was performed to identify effects of pneumoperitoneum on hemodynamic changes of hypertensive patients undergoing laparoscopic colectomy under general anesthesia.
Methods
Data collection was done from January 2 to June 10, 2008. Seventy-six patients, including 38 hypertensive patients, who had taken antihypertensive drugs more than 1 month and 38 normotensive patients undergoing laparoscopic colectomy were enrolled in this study. The hemodynamic parameters were heart rate (HR), mean arterial pressure (MAP) and cardiac output (CO) which were measured 7 times from before induction of anesthesia to 5 min after deflation of the pneumoperitoneum. Collected data were analyzed using Repeated Measures ANOVA and Bonferroni comparison method.
Results
HR in the hypertensive group was significantly decreased at deflation of the pneumoperitoneum and 5 min after deflation of the pneumoperitoneum (p=.012). MAP in the hypertensive group was not different from the normotensive group (p=.756). CO in hypertensive group was significantly lower than normotensive group (p<.001) from immediately after pneumoperitoneum to 5 min after deflation of the pneumoperitoneum.
Conclusion
The results indicate that pneumoperitoneum during laparoscopic surgery does not lead to clinically negative hemodynamic changes in heart rate, mean arterial pressure or cardiac output of hypertensive patients, who have taken antihypertensive drugs for more than 1 month.

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