High-flow nasal oxygen (HFNO) has been found to be noninferior to noninvasive ventilation (NIV) for patients with acute respiratory failure, according to a recent study published in the Journal of the American Medical Association. The study, conducted by Israel S. Maia, M.D., Ph.D., and colleagues from the HCor Research Institute in São Paulo, Brazil, aimed to compare the rates of endotracheal intubation or death within seven days between HFNO and NIV.
A total of 1,766 hospitalized patients with acute respiratory failure were randomly assigned to receive either HFNO or NIV. The primary outcome of endotracheal intubation or death within seven days occurred in 39 percent of patients in the HFNO group and 38 percent in the NIV group overall. Subgroup analysis revealed varying rates of the primary outcome among different patient groups, with immunocompromised patients with hypoxemia showing higher rates in the HFNO group compared to the NIV group.
Overall, the incidence of serious adverse events was similar between the HFNO and NIV groups, with 9.4 percent and 9.9 percent, respectively. The authors noted that further studies are needed to explore the efficacy of HFNO in specific patient populations, such as those with chronic obstructive pulmonary disease, immunocompromised patients, and acute cardiogenic pulmonary edema.
In conclusion, the study suggests that HFNO is a viable alternative to NIV for most patients with acute respiratory failure. Future research should focus on optimizing the use of HFNO in different clinical scenarios to maximize its benefits for patients.
For more information on the study, please refer to the original article published in JAMA.
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