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Demographic, clinical, respiratory support, oxygenation failure, and survival data were collected. Oxygenation failure was defined as either intubation or death in the ICU without intubation. Variables independently associated with oxygenation failure and Day mortality were assessed using multivariate logistic regression.
Randomized controlled trials are needed. Understanding how clinicians can address the demand for emergency mass critical care and fine-tune the standard of care regarding oxygenation management is of the utmost importance. For instance, guidance about how to allocate scarce critical care resources such as ventilators should be made using data showing that safe alternatives to standard oxygen therapy can avoid intubation without lessening survival probabilities.
In patients with de novo acute respiratory failure admitted to the intensive care unit ICU , high-flow nasal cannula oxygen HFNC and noninvasive mechanical ventilation NIV improve oxygenation and reduce inspiratory effort and the work of breathing [ 1 β 3 ].
High-flow nasal cannula oxygen has shown clinical benefit by reducing the intubation rate [ 4 ], and its use is now recommended in de novo acute respiratory failure [ 5 ]. Noninvasive ventilation decreases the intubation rate [ 6 ], but NIV failure and subsequent intubation is associated with higher mortality compared to first-line intubation [ 7 ], and NIV is not recommended in de novo acute respiratory failure [ 6 ].
