Trial reportIntensive care medicine2014
Helmet CPAP vs. oxygen therapy in severe hypoxemic respiratory failure due to pneumonia.
Trial report in Intensive care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 79 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Open Randomized Controlled Clinical Trial Comparing Oxygen Therapy by High Flow Nasal Cannulae and by Venturi Mask in the Treatment of Acute Respiratory Failure Due to Severe Pneumonia (Hi Flow Oxygen vs Venturi Mask In Pneumonia)
Mechanical Insufflation-Exsufflation Compared With CPAP in Patients Admitted to an Intermediate Care Unit With Pneumonia: a Randomised Controlled Study.
The CircumVent Project: A CPAP/O2 Helmet Solution for Non-Invasive Ventilation Using an Implementation Research Framework
Who cites it
79 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- Preoxygenation strategies before intubation in patients with acute hypoxic respiratory failure: a network meta-analysis.Frontiers in medicine · 2025Pooled it
- Noninvasive ventilation in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis of randomized controlled trials.Scientific reports · 2023Pooled it
- Efficacy of non-invasive and invasive respiratory management strategies in adult patients with acute hypoxaemic respiratory failure: a systematic review and network meta-analysis.Critical care (London, England) · 2021Pooled it
- Pooled it
- Use of a helmet for oxygen therapy in critically ill patients: a systematic review and meta-analysis.The Journal of international medical research · 2020Pooled it
- Chest physiotherapy for pneumonia in children.The Cochrane database of systematic reviews · 2019Pooled it
- Effects of non-invasive ventilation in patients with acute respiratory failure excluding post-extubation respiratory failure, cardiogenic pulmonary edema and exacerbation of COPD: a systematic review and meta-analysis.Journal of anesthesia · 2017Pooled it
- Noninvasive Ventilation in Acute Hypoxemic Nonhypercapnic Respiratory Failure: A Systematic Review and Meta-Analysis.Critical care medicine · 2017Pooled it
- Noninvasive ventilation with helmet versus control strategy in patients with acute respiratory failure: a systematic review and meta-analysis of controlled studies.Critical care (London, England) · 2016Pooled it
- Helmet CPAP versus Oxygen Therapy in Hypoxemic Acute Respiratory Failure: A Meta-Analysis of Randomized Controlled Trials.Yonsei medical journal · 2016Pooled it
- Effects of non-invasive respiratory supports on inspiratory effort in moderate-severe COVID-19 patients. A randomized physiological study.European journal of internal medicine · 2022Trial
- Trial
- A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome.Critical care (London, England) · 2019Trial
- The NAVIGATE trial: early identification and management of mild acute hypoxemic failure, does timing matter outside ICUs?Journal of thoracic disease · 2026Article
- Non-Invasive Respiratory Support in "De Novo" Acute Hypoxemic Respiratory Failure: Which Technique Is Best?Medicina (Kaunas, Lithuania) · 2026Review
- CPAP and high-flow nasal oxygen also reduce lung, diaphragm, and accessory muscle injury in experimental self-inflicted lung injury.Scientific reports · 2026Article
- A clinical guide to non-invasive respiratory support in acute respiratory failure: ventilation settings, technical optimization and clinical indications.Critical care (London, England) · 2025Review
- CPAP improves regional lung strain rate and diaphragm velocity of relaxation in experimental self-inflicted lung injury.Critical care (London, England) · 2025Article
- High-flow nasal oxygen is the reference treatment in acute hypoxemic respiratory failure: Pro.Journal of intensive medicine · 2025Review
- Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future?Journal of intensive medicine · 2025Review
19 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe efficacy of noninvasive continuous positive airway pressure (CPAP) to improve outcomes in severe hypoxemic acute respiratory failure (hARF) due to pneumonia has not been clearly established. The aim of this study was to compare CPAP vs. oxygen therapy to reduce the risk of meeting criteria for endotracheal intubation (ETI).
methodsIn a multicenter randomized controlled trial conducted in four Italian centers patients with severe hARF due to pneumonia were randomized to receive helmet CPAP (CPAP group) or oxygen delivered with a Venturi mask (control group). The primary endpoint was the percentage of patients meeting criteria for ETI, including either one or more major criteria (respiratory arrest, respiratory pauses with unconsciousness, severe hemodynamic instability, intolerance) or at least two minor criteria (reduction of at least 30% of basal PaO2/FiO2 ratio, increase of 20% of PaCO2, worsening of alertness, respiratory distress, SpO2 less than 90%, exhaustion).
resultsBetween February 2010 and 2013, 40 patients were randomized to CPAP and 41 to Venturi mask. The proportion of patients meeting ETI criteria in the CPAP group was significantly lower compared to those in the control group (6/40 = 15% vs. 26/41 = 63%, respectively, p < 0.001; relative risk 0.24, 95% CI 0.11-0.51; number needed to treat, 2) two patients were intubated in the CPAP group and one in the control group. The CPAP group showed a faster and greater improvement in oxygenation in comparison to controls (p < 0.001). In either study group, no relevant adverse events were detected.
conclusionsHelmet CPAP reduces the risk of meeting ETI criteria compared to oxygen therapy in patients with severe hARF due to pneumonia.
Indexed as
Identifiers
24817030What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.