— Showdown of HFNC and helmet- and deal with mask-based methods in meta-analysis
by Elizabeth Short, Staff Writer, MedPage Today
April 23, 2023
The offered noninvasive oxygenation methods differed in their efficiency in dealing with intense hypoxemic breathing failure (AHRF), according to a meta-analysis of randomized trials.
Helmet constant favorable air passage pressure (CPAP) was the only technique that had at least moderate certainty proof backing a likely death decrease compared to basic oxygen treatment (SOT; 231 less deaths per 1,000), reported Tyler Pitre, MD, of McMaster University in Hamilton, Ontario, and coauthors.
High-flow nasal cannula (HFNC; 103.5 less occasions per 1,000) and face mask bilevel ventilation (99 less occasions per 1,000) were the only treatments associated with lower requirement for intrusive mechanical ventilation with the limit of moderate-level proof, according to the meta-analysis released in CHEST
“Based on the offered proof, the helmet user interface is most likely remarkable compared to the facemask user interface,” Pitre’s group composed. “However, this has actually just been studied in [a] couple of little, randomized trials.”
None of the 5 oxygenation techniques studied– HFNC, helmet bilevel ventilation, helmet CPAP, face mask CPAP, and face mask bilevel ventilation– had any much better than low-certainty proof to recommend much shorter extensive care system (ICU) and medical facility stays, more ventilator-free days, and higher client convenience compared to SOT.
The authors highlighted the value in minimizing requirement for intrusive mechanical ventilation and shortenin