Excessive-flow nasal oxygen (HFNO) is noninferior to noninvasive air flow (NIV) for endotracheal intubation or loss of life inside seven days for many sufferers with acute respiratory failure, in line with a research revealed on-line Dec. 10 within the Journal of the American Medical Affiliation to coincide with the Vital Care Critiques Down Beneath assembly, held from Dec. 10 to 11 in Melbourne, Australia.
Israel S. Maia, M.D., Ph.D., from the HCor Analysis Institute in São Paulo, Brazil, and colleagues assessed whether or not HFNO is noninferior to NIV on the charges of endotracheal intubation or loss of life at seven days. The researchers randomly assigned 1,766 hospitalized sufferers with acute respiratory failure (labeled into 5 teams) to HFNO (883 sufferers) or NIV (883 sufferers).
The researchers discovered that the first end result of endotracheal intubation or loss of life inside seven days occurred in 39 % within the HFNO group versus 38 % within the NIV group total. The first end result occurred on the following charges within the immunocompromised affected person group with hypoxemia: 57.1 % within the HFNO group versus 36.4 % within the NIV group, with enrollment stopped for futility. The corresponding charges had been 32.5 versus 33.1 % within the nonimmunocompromised group with hypoxemia; 10.3 versus 21.3 % within the acute cardiogenic pulmonary edema group; 51.3 versus 47.0 % within the hypoxemic COVID-19 group; and 28.6 versus 26.2 % within the group with persistent obstructive pulmonary illness exacerbation with respiratory acidosis. The incidence of significant opposed occasions was related between the teams (HFNO: 9.4 %; NIV: 9.9 %).
“The small sample sizes in some patient groups and the sensitivity of the findings to the choice of analysis model suggests the need for further study in patients with chronic obstructive pulmonary disease, immunocompromised patients, and patients with acute cardiogenic pulmonary edema,” the authors write.
One writer disclosed ties to Roche Diagnostics, Novartis, and Bayer.
Extra info:
Excessive-Stream Nasal Oxygen vs Noninvasive Air flow in Sufferers With Acute Respiratory Failure, JAMA (2024). DOI: 10.1001/jama.2024.26244
Jean-Pierre Frat et al, Is Excessive-Stream Oxygen the Normal for All Sufferers With Acute Respiratory Failure?, JAMA (2024). DOI: 10.1001/jama.2024.25906More Info
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Excessive-flow nasal oxygen noninferior to noninvasive air flow for acute respiratory failure (2024, December 16)
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