Continuous positive airway pressure versus high-flow nasal cannula oxygen therapy for acute hypoxemic respiratory failure : A randomized controlled trial
© 2023 Asian Pacific Society of Respirology..
BACKGROUND AND OBJECTIVE: The relative effectiveness of initial non-invasive respiratory strategies for acute respiratory failure using continuous positive airway pressure (CPAP) or high-flow nasal cannula (HFNC) is unclear.
METHODS: We conducted a multicenter, open-label, parallel-group randomized controlled trial to compare the efficacy of CPAP and HFNC on reducing the risk of meeting the prespecified criteria for intubation and improving clinical outcomes of acute hypoxemic respiratory failure. The primary endpoint was the time taken to meet the prespecified criteria for intubation within 28 days.
RESULTS: Eighty-five patients were randomly assigned to the CPAP or HFNC group. Eleven (28.9%) in the CPAP group and twenty (42.6%) in the HFNC group met the criteria for intubation within 28 days. Compared with HFNC, CPAP reduced the risk of meeting the intubation criteria (hazard ratio [HR], 0.327; 95% CI, 0.148-0.724; p = 0.006). There were no significant between-group differences in the intubation rates, in-hospital and 28-day mortality rates, ventilator-free days, duration of the need for respiratory support, or duration of hospitalization for respiratory illness. Pulmonary oxygenation was significantly better in the CPAP group, with significantly lower pH and higher partial pressure of carbon dioxide, but there were no differences in the respiratory rate between groups. CPAP and HFNC were associated with few possibly causal adverse events.
CONCLUSION: CPAP is more effective than HFNC at reducing the risk of meeting the intubation criteria in patients with acute hypoxemic respiratory failure.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 2023 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
|---|---|
| Enthalten in: |
Respirology (Carlton, Vic.) - 29(2023), 1 vom: 01. Jan., Seite 36-45 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Nagata, Kazuma [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute hypoxemic respiratory failure |
|---|
| Anmerkungen: |
Date Completed 22.12.2023 Date Revised 22.12.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/resp.14588 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM361461151 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM361461151 | ||
| 003 | DE-627 | ||
| 005 | 20231227135851.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/resp.14588 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1235.xml |
| 035 | |a (DE-627)NLM361461151 | ||
| 035 | |a (NLM)37648252 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Nagata, Kazuma |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Continuous positive airway pressure versus high-flow nasal cannula oxygen therapy for acute hypoxemic respiratory failure |b A randomized controlled trial |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 22.12.2023 | ||
| 500 | |a Date Revised 22.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 Asian Pacific Society of Respirology. | ||
| 520 | |a BACKGROUND AND OBJECTIVE: The relative effectiveness of initial non-invasive respiratory strategies for acute respiratory failure using continuous positive airway pressure (CPAP) or high-flow nasal cannula (HFNC) is unclear | ||
| 520 | |a METHODS: We conducted a multicenter, open-label, parallel-group randomized controlled trial to compare the efficacy of CPAP and HFNC on reducing the risk of meeting the prespecified criteria for intubation and improving clinical outcomes of acute hypoxemic respiratory failure. The primary endpoint was the time taken to meet the prespecified criteria for intubation within 28 days | ||
| 520 | |a RESULTS: Eighty-five patients were randomly assigned to the CPAP or HFNC group. Eleven (28.9%) in the CPAP group and twenty (42.6%) in the HFNC group met the criteria for intubation within 28 days. Compared with HFNC, CPAP reduced the risk of meeting the intubation criteria (hazard ratio [HR], 0.327; 95% CI, 0.148-0.724; p = 0.006). There were no significant between-group differences in the intubation rates, in-hospital and 28-day mortality rates, ventilator-free days, duration of the need for respiratory support, or duration of hospitalization for respiratory illness. Pulmonary oxygenation was significantly better in the CPAP group, with significantly lower pH and higher partial pressure of carbon dioxide, but there were no differences in the respiratory rate between groups. CPAP and HFNC were associated with few possibly causal adverse events | ||
| 520 | |a CONCLUSION: CPAP is more effective than HFNC at reducing the risk of meeting the intubation criteria in patients with acute hypoxemic respiratory failure | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a acute hypoxemic respiratory failure | |
| 650 | 4 | |a continuous positive airway pressure | |
| 650 | 4 | |a high-flow nasal cannula oxygen therapy | |
| 650 | 7 | |a Oxygen |2 NLM | |
| 650 | 7 | |a S88TT14065 |2 NLM | |
| 700 | 1 | |a Yokoyama, Toshiki |e verfasserin |4 aut | |
| 700 | 1 | |a Tsugitomi, Ryosuke |e verfasserin |4 aut | |
| 700 | 1 | |a Nakashima, Harunori |e verfasserin |4 aut | |
| 700 | 1 | |a Kuraishi, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Ohshimo, Shinichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Mori, Yoshihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Sakuraya, Masaaki |e verfasserin |4 aut | |
| 700 | 1 | |a Kagami, Ryogo |e verfasserin |4 aut | |
| 700 | 1 | |a Tanigawa, Motoaki |e verfasserin |4 aut | |
| 700 | 1 | |a Tobino, Kazunori |e verfasserin |4 aut | |
| 700 | 1 | |a Kamo, Tetsuro |e verfasserin |4 aut | |
| 700 | 1 | |a Kadowaki, Toru |e verfasserin |4 aut | |
| 700 | 1 | |a Koga, Yasutaka |e verfasserin |4 aut | |
| 700 | 1 | |a Ogata, Yoshitaka |e verfasserin |4 aut | |
| 700 | 1 | |a Nishimura, Naoki |e verfasserin |4 aut | |
| 700 | 1 | |a Kondoh, Yasuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Taniuchi, Satsuki |e verfasserin |4 aut | |
| 700 | 1 | |a Shintani, Ayumi |e verfasserin |4 aut | |
| 700 | 1 | |a Tomii, Keisuke |e verfasserin |4 aut | |
| 700 | 0 | |a JaNP-Hi Study Investigators |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Respirology (Carlton, Vic.) |d 1998 |g 29(2023), 1 vom: 01. Jan., Seite 36-45 |w (DE-627)NLM093444214 |x 1440-1843 |7 nnns |
| 773 | 1 | 8 | |g volume:29 |g year:2023 |g number:1 |g day:01 |g month:01 |g pages:36-45 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/resp.14588 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 29 |j 2023 |e 1 |b 01 |c 01 |h 36-45 | ||