Early Noninvasive Ventilation May Not Be Better for Patients With Acute Respiratory Failure

the Oncology Nurse Advisor take:

Among immunocompromised patients admitted to intensive care units (ICUs) with hypoxemic acute respiratory failure, early noninvasive ventilation did not reduce 28-day mortality compared with oxygen therapy alone, according to a new study published online ahead of print in JAMA.

Although noninvasive ventilation has been recommended to decrease mortality among immunocompromised patients with hypoxemic acute respiratory failure, its effectiveness has remained unclear.

Therefore, researchers sought to evaluate whether early noninvasive ventilation improved survival in these patients.

For the multicenter trial, researchers enrolled 374 critically ill immunocompromised patients at 28 ICUs in France and Belgium.

Of those, nearly 85% were receiving treatment for hematologic malignancies and solid tumors. Participants were randomly assigned to receive early noninvasive ventilation or oxygen therapy alone.

Results showed that at 28 days after randomization, 46 deaths had occurred in the noninvasive ventilation group compared with 50 in the oxygen group (P=0.47). In addition, oxygenation failure occurred in 73 patients and 82 patients, respectively (P=0.20).

Researchers found no significant differences in ICU-acquired infections, duration of mechanical ventilation, or lengths of ICU or hospital stays between the two treatment arms.

The authors note that the study power was limited and this may affect the applicability of the findings.