High-flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: author's reply
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The SMART trial was a single-center study without individual patient randomization and no blinded assignment, exposed participants to moderate fluid volume, identified sepsis subgroups based on ICD-10 codes, and used a composite outcome which may not be as relevant as a patient-centered outcome.
“The SMART trial was a single-center study without individual patient randomization and no blinded assignment of the intervention, it exposed participants to moderate amount of fluid volume, identification of sepsis subgroups was based on ICD-10 codes, and it used a composite outcome which may not be as relevant as a patient-centered outcome (336).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [336]
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Experimental — accuracy not yet measuredA systematic review and meta-analysis of nine RCTs showed that HFNC reduces intubation compared with conventional oxygen (RR 0.85; 95% CI 0.74-0.99) but does not affect the risk of death or ICU length of stay.
“A systematic review and meta-analysis of nine RCTs [2] showed that HFNC reduces intubation compared with conventional oxygen (RR 0.85; 95% CI 0.74–0.99) but does not affect the risk of death or ICU length of stay [412–414].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [414]
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- Authors
- Rochwerg, B., Granton, D., Wang, D. X., Einav, S., & Burns, K. E. A.
- Affiliations
- Juravinski Hospital (CA)
- McMaster University (CA)
- Western University (CA)
- Hebrew University of Jerusalem (IL)
- University of Toronto (CA)
- Corresponding author
- Rochwerg, Bram
- Venue
- Intensive Care Medicine
- Published
- 2019-06-24
- Volume
- 45
- Issue
- 8
- Pages
- 1171-1171
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- OpenAlex
- W2952178284
- Cited by
- 178
- References
- 2
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 17 · 2023: 21 · 2022: 25 · 2021: 52 · 2020: 47 · 2019: 3
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Intensive Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Keywords
- high-flow nasal cannula, conventional oxygen therapy, acute hypoxemic respiratory failure, mechanical ventilation, oxygen delivery
- MeSH terms
- Cannula, Hypoxia, Humans, Oxygen, Oxygen Inhalation Therapy, Respiratory Insufficiency
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