Acute Respiratory Failure Clinical Trial
Official title:
High-Flow Nasal Cannula Oxygen Therapy (HFNC) Alone or Associated With Noninvasive Ventilation (NIV) for Immunocompromised Patients Admitted to Intensive Care Unit for Acute Respiratory Failure : FLORALI-Immunodéprimés
Acute respiratory failure is the leading cause of ICU admission of immunocompromized
patients. In this subgroup of patients, the need for intubation and invasive mechanical
ventilation occurs in about 50% of cases and is associated with very a high mortality rate,
reaching 70% of cases. Therefore, noninvasive oxygenation strategies have been developed to
avoid intubation.
More than 15 years ago, 2 trials have suggested that NIV could decrease intubation and
mortality rates of immunocompromized patients as compared to standard oxygen through a mask.
However these results have not been confirmed in a recent large trial.
HFNC is a recent and well-tolerated oxygenation technique. In a recent trial, HFNC alone
could decrease mortality and intubation rates in patients with ARF as compared to NIV.
Similar findings have been reported in a post-hoc analysis on immunocompromized patients
excluding those with profound neutropenia. Likewise in a retrospective monocentric cohort of
immunocompromized patients, we reported better outcomes with HFNC than with NIV.
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