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Early Noninvasive Ventilation Doesn't Cut Mortality in ICU

No reduction in mortality versus oxygen therapy alone for immunocompromised patients

THURSDAY, Oct. 8, 2015 (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 Oct. 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 Oct. 3 to 7 in Berlin.

Virginie Lemiale, M.D., from Saint-Louis University Hospital in Paris, and colleagues conducted a multicenter randomized trial among 374 critically ill immunocompromised patients, of whom 84.7 percent 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 9 L/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 percent 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 percent overall: 38.2 and 44.8 percent 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.

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