Abstract
Acute respiratory failure (ARF) is a prevalent and serious condition in intensive care unit (ICU), often associated with high mortality rates. High-flow nasal oxygen (HFNO) therapy has gained popularity for treating ARF in recent years. However, there is a limited understanding of the factors that predict HFNO failure in ARF patients. This study aimed to explore early indicators of HFNO failure in ARF patients, utilizing machine learning (ML) algorithms to more accurately pinpoint individuals at elevated risk of HFNO failure. Utilizing ML algorithms, we developed seven predictive models. Their performance was evaluated using various metrics, including the area under the receiver operating characteristic curve, calibration curve, and precision recall curve. The study enrolled 700 patients, with 490 in the training group and 210 in the validation group. The overall HFNO failure rate was 14.1% among the 700 patients. The ML algorithms demonstrated robust performance in our study. This research underscores the potential of ML techniques in creating clinically relevant models for predicting HFNO outcomes in ARF patients. These models could play a pivotal role in enhancing the risk management of HFNO, leading to more patient-centered and personalized care approaches.