دورية أكاديمية
High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure
| العنوان: | High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure |
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| المؤلفون: | Frat, J. P., Thille, A. W., Mercat, A., Girault, C., Ragot, S., Perbet, S., Prat, G., Boulain, T., Morawiec, E., Cottereau, A., Devaquet, J., Nseir, S., Razazi, K., Mira, J. P., Argaud, Laurent, Chakarian, J. C., Ricard, J. D., Wittebole, X., Chevalier, S., Herbland, A., Fartoukh, M., Constantin, J. M., Tonnelier, J. M., Pierrot, M., Mathonnet, A., Beduneau, G., Deletage-Metreau, C., Richard, J. C., Brochard, L., Robert, R., Group, Florali Study, Network, Reva |
| المساهمون: | Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| المصدر: | ISSN: 0028-4793. |
| بيانات النشر: | HAL CCSD Massachusetts Medical Society |
| سنة النشر: | 2015 |
| المجموعة: | HAL Lyon 1 (University Claude Bernard Lyon 1) |
| مصطلحات موضوعية: | Adult, Female, Humans, Male, Aged, Middle Aged, Kaplan-Meier Estimate, Acute Disease, Anoxia/etiology, Intubation, Intratracheal/statistics & numerical data, Oxygen Inhalation Therapy/instrumentation/*methods, Oxygen/*administration & dosage, Positive-Pressure Respiration/*instrumentation, Respiratory Insufficiency/complications/mortality/*therapy, [SDV]Life Sciences [q-bio] |
| الوصف: | International audience ; BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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 Interregional 2010 of the French Ministry of ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | hal-01850556; https://hal.science/hal-01850556Test |
| DOI: | 10.1056/NEJMoa1503326 |
| الإتاحة: | https://doi.org/10.1056/NEJMoa1503326Test https://hal.science/hal-01850556Test |
| رقم الانضمام: | edsbas.1EDFBB3E |
| قاعدة البيانات: | BASE |
| DOI: | 10.1056/NEJMoa1503326 |
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