Evidence map›Paper›PMID 26521922›Full record

Trial reportCritical care (London, England)2015

The effects of a 2-h trial of high-flow oxygen by nasal cannula versus Venturi mask in immunocompromised patients with hypoxemic acute respiratory failure: a multicenter randomized trial.

Virginie Lemiale, Djamel Mokart, Julien Mayaux, Jérôme Lambert, Antoine Rabbat, Alexandre Demoule, Elie Azoulay

3 registry-linked trialsOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 65 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 16 pooled it
12.7field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02424773 phase3completednot on this map

Oxygen Therapy During Acute Respiratory Failure in Immuno-compromised Patients

TypeinterventionalSponsorAssistance Publique - Hôpitaux de ParisRan2012 to 2015Enrolled100ConditionsAcute Respiratory Failure, Immunocompromised Host, High Flow Oxygen CannulaArmsHigh Flow Nasal Canula (HFNC), Venturi mask, Oxygen
NCT03133520 nacompletednot on this mapstarted 2016, after this paper: background citation

Effectiveness of High Flow Oxygen Therapy in Patients With Hematologic Malignancy Acute Hypoxemic Respiratory Failure

TypeinterventionalSponsorKursat GundoganRan2016 to 2018Enrolled102ConditionsAcute Hypoxemic Respiratory Failure, Hematologic MalignancyArmsHigh flow oxygen therapy
NCT03460119 completednot on this map

Use of High-Flow Nasal Cannula for Acute Respiratory Failure in the Emergency Department

TypeobservationalSponsorHospital Italiano de Buenos AiresRan2015 to 2017Enrolled43ConditionsAcute Respiratory FailureArmsHigh Flow Nasal Cannula Oxygen
3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 16 syntheses or guidelines pooled it, 147 citations in OpenAlex.

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5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Virginie LemialeMedical ICU, Saint Louis Teaching Hospital, AP-HP, 1 avenue Claude Vellefaux, 75010, Paris, France. virginie.lemiale@aphp.fr.
Djamel MokartMedical-Surgical ICU, Institut Paoli Calmettes, 13000, Marseilles, France. mokartd@ipc.unicancer.fr.
Julien MayauxBiostatistics Department, Saint Louis Teaching Hospital, AP-HP, Paris, France. julien.mayaux@aphp.fr.
Jérôme LambertRespiratory ICU, Pitié Salpétrière Teaching Hospital, AP-HP, Paris, France. jerome.lambert@paris7.jussieu.fr.
Antoine RabbatRespiratory ICU, Cochin Teaching Hospital, AP-HP, Paris, France. antoine.rabbat@aphp.fr.
Alexandre DemouleBiostatistics Department, Saint Louis Teaching Hospital, AP-HP, Paris, France. alexandre.demoule@aphp.fr.
Elie AzoulayMedical ICU, Saint Louis Teaching Hospital, AP-HP, 1 avenue Claude Vellefaux, 75010, Paris, France. elie.azoulay@aphp.fr.
Hôpital Saint-Louis · FRAssistance Publique – Hôpitaux de Paris · FRInstitut Paoli-Calmettes · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn immunocompromised patients, acute respiratory failure (ARF) is associated with high mortality, particularly when invasive mechanical ventilation (IMV) is required. In patients with severe hypoxemia, high-flow nasal oxygen (HFNO) therapy has been used as an alternative to delivery of oxygen via a Venturi mask. Our objective in the present study was to compare HFNO and Venturi mask oxygen in immunocompromised patients with ARF.

methodsWe conducted a multicenter, parallel-group randomized controlled trial in four intensive care units. Inclusion criteria were hypoxemic ARF and immunosuppression, defined as at least one of the following: solid or hematological malignancy, steroid or other immunosuppressant drug therapy, and HIV infection. Exclusion criteria were hypercapnia, previous IMV, and immediate need for IMV or noninvasive ventilation (NIV). Patients were randomized to 2 h of HFNO or Venturi mask oxygen.

resultsThe primary endpoint was a need for IMV or NIV during the 2-h oxygen therapy period. Secondary endpoints were comfort, dyspnea, and thirst, as assessed hourly using a 0-10 visual analogue scale. We randomized 100 consecutive patients, including 84 with malignancies, to HFNO (n = 52) or Venturi mask oxygen (n = 48). During the 2-h study treatment period, 12 patients required IMV or NIV, and we found no significant difference between the two groups (15 % with HFNO and 8 % with the Venturi mask, P = 0.36). None of the secondary endpoints differed significantly between the two groups.

conclusionsIn immunocompromised patients with hypoxemic ARF, a 2-h trial with HFNO improved neither mechanical ventilatory assistance nor patient comfort compared with oxygen delivered via a Venturi mask. However, the study was underpowered because of the low event rate and the one-sided hypothesis.

trial registrationClinicalTrials.gov identifier: NCT02424773 . Registered 20 April 2015.

Indexed as

AdultAgedCathetersFemaleHumansHypoxiaImmunocompromised HostIntensive Care UnitsMaleMasksMiddle AgedMulticenter Studies as TopicOxygenOxygen Inhalation TherapyRespiratory InsufficiencyOxygen

Identifiers

PMID26521922
PMCPMC4629403
OpenAlexW1929972152

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.