The data are relatively convincing for hypoxemic respiratory failure but are less so for COPD exacerbations with hypercarbia.
Avoiding intubation is a priority for patients with acute respiratory failure. Data support use of noninvasive ventilation (NIV) for patients with some types (e.g., chronic obstructive pulmonary disease [COPD] exacerbations), but NIV can be uncomfortable and difficult to tolerate. Increasingly, clinicians opt to use high-flow oxygen (HFO), particularly for patients with hypoxemic respiratory failure.
Investigators from Brazil randomized nearly 1800 patients with acute respiratory failure in 33 institutions to either NIV or HFO. Patients were sorted into one of five categories as follows:
Hypercarbic COPD exacerbation (79 patients)
Hypoxemic respiratory failure due to acute cardiogenic pulmonary edema (174)
COVID-19 (895)
Immunocompromised with o…
Reviewing Author
DisclosuresEditorial BoardsATS Scholar
DisclosuresEditorial BoardsATS Scholar