Non-invasive positive pressure ventilation (NIV) has been shown to decrease the work of breathing and improve gas exchange. It has been shown to reduce the need for intubation in COPD and in cardiogenic pulmonary oedema. However we don’t have the evidence for the effectiveness of NIV in preventing intubation and improving outcomes for patients acute hyperaemic respiratory failure
The FLORALI Trial looked at high flow oxygen and compared it to NIV and standard oxygen therapy, in patients admitted to the ICU with acute hypoxemic respiratory failure to determine the impact on intubation rates and outcomes. The study states that it looked at patients with ‘acute lung injury’, however most of the patients had severe pneumonia. This is very helpful for us, as we have had little in the literature in respect to pneumonia patients. This is a good study to read.
The Study
Frat JP, et al. High Flow Oxygen Through Nasal Cannula in Acute Hypoxaemic Respiratory Failure, NEJM 2015. 372;23: 2185-2196.
What They Did
This was a prospective, multicenter, randomized, controlled trial conducted in 23 ICUs in France and Belgium.
N = 310 patients randomised to the treatments below.
