Early Noninvasive Ventilation May Not Cut Mortality in ICU
(HealthDay News) — Early noninvasive ventilation does not reduce mortality compared with oxygen therapy alone for immunocompromised patients admitted to the intensive care unit (ICU) with hypoxemic acute respiratory failure. These findings were published online October 7 in the Journal of the American Medical Association to coincide with the annual meeting of the European Society of Intensive Care Medicine, held from October 3–7 in Berlin.
Virginie Lemiale, MD, from Saint-Louis University Hospital in Paris, and colleagues conducted a multicenter randomized trial among 374 critically ill immunocompromised patients, of whom 84.7% were receiving treatment for hematologic malignancies or solid tumors. Participants were randomized to early noninvasive ventilation or oxygen therapy alone.
The researchers found that the median oxygen flow was 9L/min at randomization in both groups. The noninvasive ventilation group received their first noninvasive ventilation session immediately after randomization. On day 28 after randomization, 24.1 and 27.3% of deaths had occurred in the noninvasive ventilation and oxygen groups, respectively (absolute difference, −3.2; P=0.47). Oxygenation failure occurred in 41.4% overall: 38.2 and 44.8% in the noninvasive ventilation and oxygen groups, respectively (absolute difference, −6.6; P=0.20).
"Among immunocompromised patients admitted to the ICU with hypoxemic acute respiratory failure, early noninvasive ventilation compared with oxygen therapy alone did not reduce 28-day mortality," the authors write.