Table 1 Summary of key randomized clinical trials of non-invasive ventilation (NIV) and high-flow nasal cannula oxygen (HFNC)
Study | No. of patients | Cause of AHRF | P/F | Interventions (cmH2O) | VT (ml/ kg) | Comparator | Primary outcome | Results | Time to intubation |
|---|---|---|---|---|---|---|---|---|---|
Frat [4] | 310 | CAP (63.5%) | 155 | NPPV-PS, face mask, PS 5, PEEP 8 | 9.2 | HFNC, COT | Intubation at 28 day | 38% with HFNC, 47% with COT, and 50% with NPPV (p = 0.18 for all comparisons) | 23 h |
Lemiale [5] | 374 | Pneumonia (68.7%) | 142 | NPPV-PS, face mask, PS 2ā10, PEEP N/A | 9.1 | COT | Mortality at 28 day | 24.1% vs. 27.3%, p = 0.47 | Half of the intubation events occurred in 1 day |
Azoulay [6] | 776 | Pneumonia (77.6%) | 132 | HFNC | ā | COT | Mortality at 28 day | 35.6% vs. 36.1%, p = 0.94 | Half of the intubation events occurred in 1 day |
He [7] | 200 | CAP (94%) | 231 | NPPV-PS, face mask, PS 6, PEEP 8 | 8.1 | COT | Intubation | 10.8% vs. 9.2%, p = 0.72 | 3.65 days |
Coudroy [8] | 299 | Pneumonia (74.5%) | 147 | NPPV-PS alternating with HFNC, face mask, PS 7, PEEP 7 | 9.6 | HFNC alone | Mortality at 28 day | 35% vs. 36%, p = 0.83 | 24 h |
Ospina- Tascon [9] | 220 | COVID-19 | 104 | HFNC | ā | COT | Intubation within 28 days | 34.3% vs. 51.0%, HR 0.62 (0.39ā0.96), p = 0.03 | 25.75 h |
Perkins [10] | 1273 | COVID-19 | 114 | NPPV-CPAP, mostly face mask, PS 8.3, PEEP N/A | N/A | COT | Intubation or mortality within 30 days | 36.3% vs. 44.4%, p = 0.02 | 1.5 days |
| Ā | Ā | Ā | Ā | HFNC | ā | COT | Intubation or mortality within 30 days | 44.3% vs. 45.1%, p = 0.69 | 1 day |