Table 1.
Study | Country | Number of patients randomized | Population | Intervention details | Comparator details | Duration of follow-up for mortality | Outcomes |
---|---|---|---|---|---|---|---|
Azoulay, 201846 | France | 778 |
Inclusion: ICU patients, PaO2 < 60 mmHg or SpO2 <90% on R/A, immune-suppression Exclusion: ↑ CO2, CPE, recent surgery |
(Fisher and Paykel Healthcare) Initial settings: Flow: 50 L·min−1 FiO2: 100% Duration: not specified |
NP or mask. Initial settings: Flow: set to achieve SpO2 ≥ 95% |
28 days | Mortality (primary), need for IMV, escalation, ICU and hospital LOS, comfort and dyspnea |
Bell, 201547 | Australia | 100 |
Inclusion: ED patients, RR ≥ 25 breaths·min−1, SpO2 ≤ 93% Exclusion: Patients requiring immediate NIV or IMV |
(AIRVO2, Optiflow, Fisher & Paykel) Initial settings: Flow: 50 L·min−1 FiO2: 30% Duration: 2 hr |
NP or face mask Initial settings: O2 in both groups was titrated over a 2-hr period |
N/A | Need for IMV, escalation, comfort |
Frat, 201548 | France and Belgium | 313 |
Inclusion: ICU patients, ARF with RR > 25 breaths·min−1, PF ≤ 300, on ≥ 10 L·min−1 O2 for ≥ 15 min Exclusion: asthma, chronic lung dz, ↑ CO2, CPE, CV instability, need for IMV |
(Optiflow, MR850, Fisher and Paykel Healthcare) Initial settings: Flow: 50 L·min−1 FiO2: 100% Duration: not specified |
NRB mask Initial settings: Flow: ≥ 10 L·min−1 |
90 days | Mortality (primary), need for IMV, escalation, ICU LOS, comfort |
Geng, 202041 | China | 36 |
Inclusion: ICU, ED, or ward patients, acute asthma, PaO2 < 60 mmHg on R/A with or without ↑ CO2 Exclusion: urgent IMV, CV instability, aLOC, RR > 45 breaths·min−1, pH < 7.30 |
(AIRVO2, Fisher & Paykel) Initial settings: Flow: 30-40 L·min−1 FiO2: N/A Duration: not specified |
NP, Venturi mask, or storage balloon mask Initial settings: Flow: 2–6 L·min−1, set to achieve SpO2 92–96% |
N/A | Need for IMV, escalation, hospital LOS |
Jones, 201649 | New Zealand | 322 |
Inclusion: ED patients, SpO2 ≤ 92% on R/A, RR ≥ 22 breaths·min−1 Exclusion: Urgent NIV or IMV required |
(Optiflow, Fisher & Paykel Healthcare) Initial settings: Flow: 40 L·min−1 FiO2: 28% Duration: not specified |
Mask or NP Initial settings: N/A |
90 days | Mortality, need for IMV, escalation (primary), hospital LOS |
Lemiale, 201545 | France | 102 |
Inclusion: ICU patients, immune-compromised, > 6 L·min−1 O2 to maintain SpO2 > 95% or respiratory distress Exclusion: ↑ CO2, urgent NIV or IMV required |
(Fisher & Paykel Healthcare) Initial settings: Flow: 40–50 L·min−1 FiO2: 100% Duration: 2 hr |
Venturi mask Initial settings: Flow: 15 L·min−1 FiO2: 60% |
N/A | Need for IMV, escalation (primary), dyspnea, comfort |
Makdee, 201744 | Thailand | 136 |
Inclusion: ED patients, CPE, SpO2 < 95% on R/A, RR >24 breaths·min−1 Exclusion: Urgent NIV or IMV required, CV instability, RR >35 breaths·min−1, SpO2 < 90%, ESRD |
(Optiflow, Fisher & Paykel Healthcare) Initial settings: Flow: 35 L·min−1 FiO2: N/A Duration: 1 hr |
NP or NRB Initial settings: N/A |
7 days | Mortality, need for IMV, escalation, hospital LOS, dyspnea, comfort |
Parke, 201150 | New Zealand | 60 |
Inclusion: ICU patients, ≥ 4 L·min−1 O2 via NP for > 4 hr or ≥ 6 L·min−1 O2 via a face mask for > 2 hr and/or RR ≥ 25 breaths·min−1 and/or ↑ WOB Exclusion: Urgent NIV or IMV required |
(Optiflow, Fisher & Paykel Healthcare) Initial settings: Flow: 35 L·min−1 FiO2: N/A Duration: not specified |
Face mask Initial settings: N/A |
N/A | Escalation |
Raeisi, 201942 | Iran | 40 |
Inclusion: ED or ward patients, moderate to severe asthma exacerbation Exclusion: Pregnancy with history of smoking and occupational asthma, ↑ CO2, Infiltrates on chest x-ray |
Device not specified Initial settings: Flow: 19.5–30 L·min−1 FiO2: N/A Duration: not specified |
NP Initial settings: Flow: 2–5 L·min−1 |
N/A | Dyspnea |
Rittayamai, 201551 | Thailand | 40 |
Inclusion: ED patients, RR > 24 breaths·min−1, SpO2 < 94% on R/A Exclusion: Need for IMV, CV instability, CRF |
(Optiflow, Fisher & Paykel Healthcare) Initial settings: Flow: 35 L·min−1 FiO2: N/A Duration: 1 hr |
NP or NRB Initial settings: N/A |
N/A | Need for IMV, escalation, dyspnea (primary), comfort |
Ruangsomboon, 201943 | Thailand | 48 |
Inclusion: ED palliative patients, SpO2 < 90%, RR ≥ 30 breaths·min−1, dyspneic Exclusion: aLOC, unable to communicate, positive pressure devices contraindicated |
(AIRVO2, Optiflow, Fisher & Paykel) Initial settings: Flow: 35 L·min−1 FiO2: N/A Duration: 1 hr |
NP or NRB Initial settings: Set to achieve SpO2 > 95% |
N/A | Dyspnea |
Schwabbauer, 201452 (crossover) |
Germany | 14 |
Inclusion: ICU patients, PaO2 < 55 mmHg on R/A Exclusion: CPE, CV instability |
(OptiFlow, Fisher & Paykel Healthcare) Initial settings: Flow: 55 L·min−1 FiO2: 60% Duration: 30 min |
Venturi mask Initial settings: Flow: 15 L·min−1 FiO2: 60% |
N/A | Dyspnea and comfort |
aLOC = altered level of consciousness; ARF = acute respiratory failure; CPE = cardiogenic pulmonary edema; CRF = chronic respiratory failure; CV = cardiovascular; Dz = disease; ESRD = end stage renal disease; ED = emergency department; ESRD = end-stage renal disease; ICU = intensive care unit; IMV = invasive mechanical ventilation; LOS = length of stay; NIV = non-invasive ventilation; NP = nasal prongs; NRB = non-rebreathe mask; PaO2 = partial pressure of oxygen; PF = PaO2:FiO2 ratio; R/A = room air; RR = respiratory rate; SpO2 = peripheral oxygen saturation; WOB = work of breathing