Annals of Intensive Care最新文献

{"title":"Changes in portal pulsatility index induced by a fluid challenge in patients with haemodynamic instability and systemic venous congestion: a prospective cohort study.","authors":"Martin Ruste, Rehane Reskot, Rémi Schweizer, Valentin Mayet, Jean-Luc Fellahi, Matthias Jacquet-Lagrèze","doi":"10.1186/s13613-024-01391-2","DOIUrl":"10.1186/s13613-024-01391-2","url":null,"abstract":"<p><strong>Background: </strong>It is uncertain whether fluid administration can improve patients with systemic venous congestion and haemodynamic instability. This study aimed to describe the changes in systemic venous congestion and peripheral perfusion parameters induced by a fluid challenge in these patients, and to analyse the influence of the fluid responsiveness status on these changes.</p><p><strong>Methods: </strong>The study is a single-centre prospective cohort study of 36 critically ill ICU patients with haemodynamic instability and a maximum vena cava diameter ≥ 20 mm. Changes in cardiac index during a fluid challenge (4 mL/kg of lactated Ringer's solution during 5 min) assessed by pulse contour analysis, central venous pressure, ultrasound systemic congestion parameters (portal venous flow pulsatility index, supra hepatic and intrarenal venous Doppler), and peripheral perfusion parameters (capillary refill time and peripheral perfusion index) were assessed in the overall population. All these data were compared between patients presenting a cardiac index increase > 10% during the fluid challenge (fluid responders) and the others (fluid non-responders).</p><p><strong>Results: </strong>Twenty-eight (78%) patients were admitted for postoperative care following cardiac surgery; their mean ± SD left ventricular ejection fraction was 42 ± 9% and right ventricular dysfunction was found in at least 61% of the patients. The mean ± SD SOFA score was 9 ± 3. Thirteen (36%) patients were fluid responders. The fluid challenge administration induced a significant increase in portal pulsatility index, VExUS score, and central venous pressure without significant difference of these changes between fluid responders and non-responders. No significant change in perfusion parameters was observed.</p><p><strong>Conclusion: </strong>Fluid administration in patients with haemodynamic instability and systemic venous congestion worsens venous congestion regardless of the fluid responsiveness status, without improving perfusion parameters.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroid treatment in COVID-19 patients receiving extracorporeal membrane oxygenation: benefit from rational use - authors' reply.","authors":"Ryan Ruiyang Ling, Daniel Brodie, Graeme MacLaren, Kollengode Ramanathan","doi":"10.1186/s13613-024-01399-8","DOIUrl":"10.1186/s13613-024-01399-8","url":null,"abstract":"","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early sedation using ciprofol for intensive care unit patients requiring mechanical ventilation: a pooled post-hoc analysis of data from phase 2 and phase 3 trials.","authors":"Yongjun Liu, Lingyun Zuo, Xiaoyun Li, Yao Nie, Chuanxi Chen, Ning Liu, Minying Chen, Jianfeng Wu, Xiangdong Guan","doi":"10.1186/s13613-024-01390-3","DOIUrl":"https://doi.org/10.1186/s13613-024-01390-3","url":null,"abstract":"<p><strong>Background: </strong>Ciprofol was approved for use in intensive care unit (ICU) patients requiring sedation during mechanical ventilation in July 2022. A pooled post-hoc analysis of phase 2 and phase 3 trials was conducted primarily to explore hypotension-free outcome in ICU patients who required mechanical ventilation and achieved the target light sedation goal at an early stage after being sedated with ciprofol or propofol.</p><p><strong>Methods: </strong>All eligible ICU patients who were expected to require sedation for 6-24 h were randomly assigned in a 2:1 ratio to either a ciprofol or propofol group. Ciprofol or propofol was initially infused at loading doses of 0.5 or 1.0 mg/kg followed by maintenance doses of 0.3 or 1.5 mg/kg/h. Ciprofol or propofol dosages were adjusted up or down at rates of 0.05-0.10 mg/kg/h or 0.25-0.50 mg/kg/h, respectively, to achieve the target light sedation (a Richmond Agitation-Sedation Scale of -2 to + 1). The primary post-hoc outcome was the hypotension-free rate in patients who had achieved the target sedation goal after 30-min administration of ciprofol or propofol.</p><p><strong>Results: </strong>In total, 174 patients were enrolled for pooled post-hoc analysis, of whom 116 and 58 were assigned to the ciprofol and propofol groups, respectively. The hypotension-free rate was significantly higher in patients who achieved the target sedation goal after 30-min administration of ciprofol (93.0% vs. 81.0%, P = 0.018), and especially in the subgroups of males and patients aged < 65 years. Multivariable analysis revealed that ciprofol treatment, a younger age and lower baseline body mass index were independent favorable predictors for a higher hypotension-free rate in patients who achieved the target sedation goal after 30-min of drug administration. Moreover, hypotension-free patients who reached the target sedation level after 30 min had a more favorable short-term prognosis including a lower incidence of drug-related treatment-emergent adverse events, shorter time to extubation and fewer dose adjustments of ciprofol or propofol (all P < 0.05).</p><p><strong>Conclusion: </strong>ICU patients undergoing mechanical ventilation and sedated with ciprofol had significantly lower rate of hypotension during the early phase of achieving light sedation during a 6-24 h period, leading to a more favorable short-term prognosis (within 24 h).</p><p><strong>Trial registration: </strong>Phase 2 trial (clinicaltrials.gov, NCT04147416. Registered November 1, 2019, https://classic.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/NCT04147416 ) and phase 3 trial (clinicaltrials.gov, NCT04620031. Registered November 6, 2020, https://classic.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/NCT04620031 ).</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroid treatment in COVID-19 patients receiving extracorporeal membrane oxygenation: benefit from rational use.","authors":"Guangting Zeng, Zanling Zhang","doi":"10.1186/s13613-024-01397-w","DOIUrl":"https://doi.org/10.1186/s13613-024-01397-w","url":null,"abstract":"","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodologies and clinical applications of lower limb muscle ultrasound in critically ill patients: a systematic review and meta-analysis.","authors":"Roberto Venco, Alessandro Artale, Paolo Formenti, Cristian Deana, Giovanni Mistraletti, Michele Umbrello","doi":"10.1186/s13613-024-01395-y","DOIUrl":"https://doi.org/10.1186/s13613-024-01395-y","url":null,"abstract":"<p><strong>Background: </strong>Reduced muscle mass upon admission and development of muscle wasting are frequent in critically ill patients, and linked to unfavorable outcomes. Muscle ultrasound is a promising instrument for evaluating muscle mass. We summarized the findings of lower limb muscle ultrasound values and investigated how the muscle ultrasound parameters of the examination or the patient characteristics influence the results.</p><p><strong>Methods: </strong>Systematic review and meta-analysis of studies of lower limb ultrasound critically ill adults. PubMed, CINAHL, Embase, PEDro and Web of Science were searched. PRISMA guidelines were followed, and studies evaluated with the appropriate NIH quality assessment tool. A meta-analysis was conducted to compare the values at admission, short and long follow-up during ICU stay, and the association between baseline values and patient characteristics or ultrasound parameters was investigated with a meta-regression.</p><p><strong>Results: </strong>Sixty-six studies (3839 patients) were included. The main muscles investigated were rectus femoris cross-sectional area (RF-CSA, n = 33/66), quadriceps muscle layer thickness (n = 32/66), and rectus femoris thickness (n = 19/66). Significant differences were found in the anatomical landmark and ultrasound settings. At ICU admission, RF-CSA ranged from 1.1 [0.73-1.47] to 6.36 [5.45-7.27] cm² (pooled average 2.83 [2.29-3.37] cm²) with high heterogeneity among studies (I² = 98.43%). Higher age, higher BMI, more distal landmark and the use of probe compression were associated with lower baseline muscle mass.</p><p><strong>Conclusions: </strong>Measurements of muscle mass using ultrasound varied with reference to patient characteristics, patient position, anatomical landmarks used for measurement, and the level of compression applied by the probe; this constrains the external validity of the results and highlights the need for standardization.</p><p><strong>Study registration: </strong>PROSPERO CRD42023420376.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-lung asymmetrical airway closure cause insufflation delay between lungs in acute hypoxemic respiratory failure.","authors":"Hadrien Rozé, Eline Bonnardel, Eloise Gallo, Clément Boisselier, Pierre Khan, Virginie Perrier, Benjamin Repusseau, Laurent Brochard","doi":"10.1186/s13613-024-01379-y","DOIUrl":"https://doi.org/10.1186/s13613-024-01379-y","url":null,"abstract":"<p><strong>Background: </strong>Electrical Impedance Tomography (EIT) can quantify ventilation in the two lungs and be used to measure the airway opening pressure (AOP) of each lung. Asymmetrical AOPs can cause inter-lung insufflation delay.</p><p><strong>Objectives: </strong>To assess the relation between AOP asymmetry and inter-lung insufflation delay at different PEEP levels.</p><p><strong>Methods: </strong>Patients with acute hypoxemic respiratory failure and airway closure were included. Low-flow pressure-volume curves and EIT signal were recorded during controlled ventilation and for some patients in pressure support ventilation.</p><p><strong>Results: </strong>23 patients were studied, 22 patients had ARDS, 9 patients had asymmetrical airway closure with an AOP of 10 [6-13] cmH₂0 in the sicker lung (AOP_sicker) vs. 5 [3-9, ] cmH₂0 in the healthier lung. During a low flow inflation, the inter-lung inflation delay was 0 [0-112]ms vs. 1450 [375-2400]ms in patients without or with asymmetrical AOPs, p < 0.0001. This delay was correlated to the difference of AOP between the 2 lungs, Spearman R² = 0.800, p < 0.0001. During tidal ventilation, median delay was 0 [0-62] ms vs. 150 [50-355] ms in patients without vs. with asymmetry, p = 0.019. Setting PEEP at the crossing point of a decremental EIT-based PEEP trial decreased the inter-lung insufflation delay. During pressure support insufflation delay could still be measured and was reduced by increasing PEEP from 5 to 10 cmH₂O in patient with asymmetrical lung injury.</p><p><strong>Conclusion: </strong>In asymmetrical airway closure, titrating PEEP can minimize inter-lung insufflation delay and can be monitored by EIT. Reducing the delay and reducing ventilation asymmetry is also feasible during pressure support ventilation when low flow inflation curves cannot be performed.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organ crosstalk and dysfunction in Sepsis: harnessing emerging biotechnologies for future breakthroughs.","authors":"Alexandre Pierre, Steve Lancel, Sebastien Preau","doi":"10.1186/s13613-024-01398-9","DOIUrl":"https://doi.org/10.1186/s13613-024-01398-9","url":null,"abstract":"","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunological sub-phenotypes and response to convalescent plasma in COVID-19 induced ARDS: a secondary analysis of the CONFIDENT trial.","authors":"Benoît Misset, Anh Nguyet Diep, Axelle Bertrand, Michael Piagnerelli, Eric Hoste, Isabelle Michaux, Elisabeth De Waele, Alexander Dumoulin, Philippe G Jorens, Emmanuel van der Hauwaert, Frédéric Vallot, Walter Swinnen, Nicolas De Schryver, Nathalie de Mey, Nathalie Layios, Jean-Baptiste Mesland, Sébastien Robinet, Etienne Cavalier, Anne-Françoise Donneau, Michel Moutschen, Pierre-François Laterre","doi":"10.1186/s13613-024-01392-1","DOIUrl":"10.1186/s13613-024-01392-1","url":null,"abstract":"<p><strong>Background: </strong>Convalescent plasma (CP) reduced the mortality in COVID-19 induced ARDS (C-ARDS) patients treated in the CONFIDENT trial. As patients are immunologically heterogeneous, we hypothesized that clusters may differ in their treatment responses to CP.</p><p><strong>Methods: </strong>We measured 20 cytokines, chemokines and cell adhesion markers using a multiplex technique at the time of inclusion in the CONFIDENT trial in patients of centers having accepted to participate in this secondary study. We performed descriptive statistics, unsupervised hierarchical cluster analysis, and examined the association between the clusters and CP effect on day-28 mortality.</p><p><strong>Results: </strong>Of the 475 patients included in CONFIDENT, 391 (82%) were sampled, and 196/391 (50.1%) had been assigned to CP. We identified four sub-phenotypes representing 89 (22.8%), 178 (45.5%), 38 (9.7%), and 86 (22.0%) patients. The most contributing biomarkers in the principal component analysis were IL-1β, IL-12p70, IL-6, IFN-α, IL-17A, IFN-γ, IL-13, TFN-α, total IgG, and CXCL10. Sub-phenotype-1 displayed a lower immune response, sub-phenotype-2 a higher adaptive response, sub-phenotype-3 the highest innate antiviral, pro and anti-inflammatory response, and adhesion molecule activation, and sub-phenotype-4 a higher pro and anti-inflammatory response, migration protein and adhesion molecule activation. Sub-phenotype-2 and sub-phenotype-4 had higher severity at the time of inclusion. The effect of CP treatment on mortality appeared higher than standard care in each sub-phenotype, without heterogeneity between sub-phenotypes (p = 0.97).</p><p><strong>Conclusion: </strong>In patients with C-ARDS, we identified 4 sub-phenotypes based on their immune response. These sub-phenotypes were associated with different clinical profiles. The response to CP was similar across the 4 sub-phenotypes.</p><p><strong>Trial registration: </strong>Ethics Committee of the University Hospital of Liège CE 2020/239.</p><p><strong>Clinicaltrials: </strong>gov NCT04558476. Registered 2020-09-11, https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT04558476 .</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting outcomes in patients with exacerbation of COPD requiring mechanical ventilation.","authors":"Obaid Alzaabi, Emmanuel Guerot, Benjamin Planquette, Jean-Luc Diehl, Thibaud Soumagne","doi":"10.1186/s13613-024-01394-z","DOIUrl":"10.1186/s13613-024-01394-z","url":null,"abstract":"<p><strong>Background: </strong>Acute exacerbations of COPD (AECOPD) are common and significantly contribute to mortality in patients with COPD. Prognostic scores can assist clinicians in making tailored decisions to manage AECOPD. In the current study, we therefore aimed to evaluate the performance of the Noninvasive Ventilation Outcomes (NIVO) score, originally designed to assess in-ICU mortality, in predicting 1 year mortality and NIV failure in AECOPD.</p><p><strong>Methods: </strong>This retrospective study analyzed data from patients hospitalized for AECOPD requiring mechanical ventilation between January 1st, 2018, and December 31st, 2022. Mortality was assessed at the end of ICU stay and 1 year after admission, while NIV failure was defined as intubation or death without intubation.</p><p><strong>Results: </strong>Among 302 ICU admissions of COPD patients, 190 patients with AECOPD requiring mechanical ventilation were included. Of these, 44 (23%) died in the ICU, 62 out of 184 (34%) failed NIV, and 78 (41%) died within 1 year of admission. Patients who died in ICU or experienced NIV failure had more severe COPD and more impaired blood gas parameters at admission. The NIVO score demonstrated an AUC of 0.68 in predicting 1-year mortality and an AUC of 0.85 in predicting NIV failure. A NIVO score over 7 was associated with higher 1-year mortality and NIV failure (HR of 4.4 [1.8-10.9] and 41.6 [5.6-307.9], respectively).</p><p><strong>Conclusion: </strong>Beyond predicting in-ICU mortality, the NIVO-score is a reliable tool in predicting 1-year mortality and NIV failure in AECOPD.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxygen therapy and noninvasive respiratory supports in acute hypoxemic respiratory failure: a narrative review.","authors":"Arnaud W Thille, Frédéric Balen, Guillaume Carteaux, Tahar Chouihed, Jean-Pierre Frat, Christophe Girault, Erwan L'Her, Nicolas Marjanovic, Mai-Anh Nay, Patrick Ray, Matthieu Reffienna, Leo Retenauer, Antoine Roch, Guillaume Thiery, Jennifer Truchot","doi":"10.1186/s13613-024-01389-w","DOIUrl":"https://doi.org/10.1186/s13613-024-01389-w","url":null,"abstract":"<p><strong>Background: </strong>This narrative review was written by an expert panel to the members of the jury to help in the development of clinical practice guidelines on oxygen therapy.</p><p><strong>Results: </strong>According to the expert panel, acute hypoxemic respiratory failure was defined as PaO₂ < 60 mm Hg or SpO₂ < 90% on room air, or PaO₂/FiO₂ ≤ 300 mm Hg. Supplemental oxygen should be administered according to the monitoring of SpO₂, with the aim at maintaining SpO₂ above 92% and below 98%. Noninvasive respiratory supports are generally reserved for the most hypoxemic patients with the aim of relieving dyspnea. High-flow nasal cannula oxygen (HFNC) seems superior to conventional oxygen therapy (COT) as a means of avoiding intubation and may therefore be should probably be used as a first-line noninvasive respiratory support in patients requiring more than 6 L/min of oxygen or PaO₂/FiO₂ ≤ 200 mm Hg and a respiratory rate above 25 breaths/minute or clinical signs of respiratory distress, but with no benefits on mortality. Continuous positive airway pressure (CPAP) cannot currently be recommended as a first-line noninvasive respiratory support, since its beneficial effects on intubation remain uncertain. Despite older studies favoring noninvasive ventilation (NIV) over COT, recent clinical trials fail to show beneficial effects with NIV compared to HFNC. Therefore, there is no evidence to support the use of NIV or CPAP as first-line treatment if HFNC is available. Clinical trials do not support the hypothesis that noninvasive respiratory supports may lead to late intubation. The potential benefits of awake prone positioning on the risk of intubation in patients with COVID-19 cannot be extrapolated to patients with another etiology.</p><p><strong>Conclusions: </strong>Whereas oxygen supplementation should be initiated for patients with acute hypoxemic respiratory failure defined as PaO₂ below 60 mm Hg or SpO₂ < 90% on room air, HFNC should be the first-line noninvasive respiratory support in patients with PaO₂/FiO₂ ≤ 200 mm Hg with increased respiratory rate. Further studies are needed to assess the potential benefits of CPAP, NIV through a helmet and awake prone position in patients with acute hypoxemic respiratory failure not related to COVID-19.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}