PubMed:25981908
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PubMed/sourceid/25981908","sourcedb":"PubMed","sourceid":"25981908","source_url":"http://www.ncbi.nlm.nih.gov/pubmed/25981908","text":"High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure.\nBACKGROUND: Whether noninvasive ventilation should be administered in patients with acute hypoxemic respiratory failure is debated. Therapy with high-flow oxygen through a nasal cannula may offer an alternative in patients with hypoxemia.\nMETHODS: We performed a multicenter, open-label trial in which we randomly assigned patients without hypercapnia who had acute hypoxemic respiratory failure and a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen of 300 mm Hg or less to high-flow oxygen therapy, standard oxygen therapy delivered through a face mask, or noninvasive positive-pressure ventilation. The primary outcome was the proportion of patients intubated at day 28; secondary outcomes included all-cause mortality in the intensive care unit and at 90 days and the number of ventilator-free days at day 28.\nRESULTS: A total of 310 patients were included in the analyses. The intubation rate (primary outcome) was 38% (40 of 106 patients) in the high-flow-oxygen group, 47% (44 of 94) in the standard group, and 50% (55 of 110) in the noninvasive-ventilation group (P=0.18 for all comparisons). The number of ventilator-free days at day 28 was significantly higher in the high-flow-oxygen group (24±8 days, vs. 22±10 in the standard-oxygen group and 19±12 in the noninvasive-ventilation group; P=0.02 for all comparisons). The hazard ratio for death at 90 days was 2.01 (95% confidence interval [CI], 1.01 to 3.99) with standard oxygen versus high-flow oxygen (P=0.046) and 2.50 (95% CI, 1.31 to 4.78) with noninvasive ventilation versus high-flow oxygen (P=0.006).\nCONCLUSIONS: In patients with nonhypercapnic acute hypoxemic respiratory failure, treatment with high-flow oxygen, standard oxygen, or noninvasive ventilation did not result in significantly different intubation rates. There was a significant difference in favor of high-flow oxygen in 90-day mortality. (Funded by the Programme Hospitalier de Recherche Clinique Interrégional 2010 of the French Ministry of Health; FLORALI ClinicalTrials.gov number, NCT01320384.).","tracks":[{"project":"luoyt2021_800_3","denotations":[{"id":"T1","span":{"begin":42,"end":77},"obj":"DP"},{"id":"T2","span":{"begin":163,"end":198},"obj":"DP"},{"id":"T3","span":{"begin":1731,"end":1766},"obj":"DP"},{"id":"T4","span":{"begin":439,"end":474},"obj":"DP"}],"attributes":[{"subj":"T1","pred":"source","obj":"luoyt2021_800_3"},{"subj":"T2","pred":"source","obj":"luoyt2021_800_3"},{"subj":"T3","pred":"source","obj":"luoyt2021_800_3"},{"subj":"T4","pred":"source","obj":"luoyt2021_800_3"}]},{"project":"Linmchun_800_3","denotations":[{"id":"T1","span":{"begin":58,"end":77},"obj":"DP"},{"id":"T2","span":{"begin":179,"end":198},"obj":"DP"},{"id":"T3","span":{"begin":455,"end":474},"obj":"DP"},{"id":"T4","span":{"begin":1747,"end":1766},"obj":"DP"}],"attributes":[{"subj":"T1","pred":"source","obj":"Linmchun_800_3"},{"subj":"T2","pred":"source","obj":"Linmchun_800_3"},{"subj":"T3","pred":"source","obj":"Linmchun_800_3"},{"subj":"T4","pred":"source","obj":"Linmchun_800_3"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"luoyt2021_800_3","color":"#97ec93","default":true},{"id":"Linmchun_800_3","color":"#ec93b1"}]}]}}