Cargando…

High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation in AIDS Patients with Acute Respiratory Failure: A Randomized Controlled Trial

Background: Acute respiratory failure (ARF) remains the most common diagnosis for intensive care unit (ICU) admission in acquired immunodeficiency syndrome (AIDS) patients. Methods: We conducted a single-center, prospective, open-labeled, randomized controlled trial at the ICU, Beijing Ditan Hospita...

Descripción completa

Detalles Bibliográficos
Autores principales: Hao, Jingjing, Liu, Jingyuan, Pu, Lin, Li, Chuansheng, Zhang, Ming, Tan, Jianbo, Wang, Hongyu, Yin, Ningning, Sun, Yao, Liu, Yufeng, Guo, Hebing, Li, Ang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967185/
https://www.ncbi.nlm.nih.gov/pubmed/36836213
http://dx.doi.org/10.3390/jcm12041679
_version_ 1784897201712922624
author Hao, Jingjing
Liu, Jingyuan
Pu, Lin
Li, Chuansheng
Zhang, Ming
Tan, Jianbo
Wang, Hongyu
Yin, Ningning
Sun, Yao
Liu, Yufeng
Guo, Hebing
Li, Ang
author_facet Hao, Jingjing
Liu, Jingyuan
Pu, Lin
Li, Chuansheng
Zhang, Ming
Tan, Jianbo
Wang, Hongyu
Yin, Ningning
Sun, Yao
Liu, Yufeng
Guo, Hebing
Li, Ang
author_sort Hao, Jingjing
collection PubMed
description Background: Acute respiratory failure (ARF) remains the most common diagnosis for intensive care unit (ICU) admission in acquired immunodeficiency syndrome (AIDS) patients. Methods: We conducted a single-center, prospective, open-labeled, randomized controlled trial at the ICU, Beijing Ditan Hospital, China. AIDS patients with ARF were enrolled and randomly assigned in a 1:1 ratio to receive either high-flow nasal cannula (HFNC) oxygen therapy or non-invasive ventilation (NIV) immediately after randomization. The primary outcome was the need for endotracheal intubation on day 28. Results: 120 AIDS patients were enrolled and 56 patients in the HFNC group and 57 patients in the NIV group after secondary exclusion. Pneumocystis pneumonia (PCP) was the main etiology for ARF (94.7%). The intubation rates on day 28 were similar to HFNC and NIV (28.6% vs. 35.1%, p = 0.457). Kaplan–Meier curves showed no statistical difference in cumulative intubation rates between the two groups (log-rank test 0.401, p = 0.527). The number of airway care interventions in the HFNC group was fewer than in the NIV group (6 (5–7) vs. 8 (6–9), p < 0.001). The rate of intolerance in the HFNC group was lower than in the NIV group (1.8% vs. 14.0%, p = 0.032). The VAS scores of device discomfort in the HFNC group were lower than that in the NIV group at 2 h (4 (4–5) vs. 5 (4–7), p = 0.042) and at 24 h (4 (3–4) vs. 4 (3–6), p = 0.036). The respiratory rate in the HFNC group was lower than that in the NIV group at 24 h (25 ± 4/min vs. 27 ± 5/min, p = 0.041). Conclusions: Among AIDS patients with ARF, there was no statistical significance of the intubation rate between HFNC and NIV. HFNC had better tolerance and device comfort, fewer airway care interventions, and a lower respiratory rate than NIV. Clinical Trial Number: Chictr.org (ChiCTR1900022241).
format Online
Article
Text
id pubmed-9967185
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99671852023-02-26 High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation in AIDS Patients with Acute Respiratory Failure: A Randomized Controlled Trial Hao, Jingjing Liu, Jingyuan Pu, Lin Li, Chuansheng Zhang, Ming Tan, Jianbo Wang, Hongyu Yin, Ningning Sun, Yao Liu, Yufeng Guo, Hebing Li, Ang J Clin Med Article Background: Acute respiratory failure (ARF) remains the most common diagnosis for intensive care unit (ICU) admission in acquired immunodeficiency syndrome (AIDS) patients. Methods: We conducted a single-center, prospective, open-labeled, randomized controlled trial at the ICU, Beijing Ditan Hospital, China. AIDS patients with ARF were enrolled and randomly assigned in a 1:1 ratio to receive either high-flow nasal cannula (HFNC) oxygen therapy or non-invasive ventilation (NIV) immediately after randomization. The primary outcome was the need for endotracheal intubation on day 28. Results: 120 AIDS patients were enrolled and 56 patients in the HFNC group and 57 patients in the NIV group after secondary exclusion. Pneumocystis pneumonia (PCP) was the main etiology for ARF (94.7%). The intubation rates on day 28 were similar to HFNC and NIV (28.6% vs. 35.1%, p = 0.457). Kaplan–Meier curves showed no statistical difference in cumulative intubation rates between the two groups (log-rank test 0.401, p = 0.527). The number of airway care interventions in the HFNC group was fewer than in the NIV group (6 (5–7) vs. 8 (6–9), p < 0.001). The rate of intolerance in the HFNC group was lower than in the NIV group (1.8% vs. 14.0%, p = 0.032). The VAS scores of device discomfort in the HFNC group were lower than that in the NIV group at 2 h (4 (4–5) vs. 5 (4–7), p = 0.042) and at 24 h (4 (3–4) vs. 4 (3–6), p = 0.036). The respiratory rate in the HFNC group was lower than that in the NIV group at 24 h (25 ± 4/min vs. 27 ± 5/min, p = 0.041). Conclusions: Among AIDS patients with ARF, there was no statistical significance of the intubation rate between HFNC and NIV. HFNC had better tolerance and device comfort, fewer airway care interventions, and a lower respiratory rate than NIV. Clinical Trial Number: Chictr.org (ChiCTR1900022241). MDPI 2023-02-20 /pmc/articles/PMC9967185/ /pubmed/36836213 http://dx.doi.org/10.3390/jcm12041679 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hao, Jingjing
Liu, Jingyuan
Pu, Lin
Li, Chuansheng
Zhang, Ming
Tan, Jianbo
Wang, Hongyu
Yin, Ningning
Sun, Yao
Liu, Yufeng
Guo, Hebing
Li, Ang
High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation in AIDS Patients with Acute Respiratory Failure: A Randomized Controlled Trial
title High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation in AIDS Patients with Acute Respiratory Failure: A Randomized Controlled Trial
title_full High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation in AIDS Patients with Acute Respiratory Failure: A Randomized Controlled Trial
title_fullStr High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation in AIDS Patients with Acute Respiratory Failure: A Randomized Controlled Trial
title_full_unstemmed High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation in AIDS Patients with Acute Respiratory Failure: A Randomized Controlled Trial
title_short High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation in AIDS Patients with Acute Respiratory Failure: A Randomized Controlled Trial
title_sort high-flow nasal cannula oxygen therapy versus non-invasive ventilation in aids patients with acute respiratory failure: a randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967185/
https://www.ncbi.nlm.nih.gov/pubmed/36836213
http://dx.doi.org/10.3390/jcm12041679
work_keys_str_mv AT haojingjing highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT liujingyuan highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT pulin highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT lichuansheng highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT zhangming highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT tanjianbo highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT wanghongyu highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT yinningning highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT sunyao highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT liuyufeng highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT guohebing highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial
AT liang highflownasalcannulaoxygentherapyversusnoninvasiveventilationinaidspatientswithacuterespiratoryfailurearandomizedcontrolledtrial