Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future?
De novo acute hypoxemic respiratory failure (AHRF) remains one of the leading causes of intensive care unit (ICU) admission and is still associated with high rates of intubation and mortality. Developing effective strategies to prevent intubation and its associated complications remains a critical o...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-07-01
|
| Series: | Journal of Intensive Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667100X25000040 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849426750751113216 |
|---|---|
| author | Guillaume Carteaux Anne-Fleur Haudebourg |
| author_facet | Guillaume Carteaux Anne-Fleur Haudebourg |
| author_sort | Guillaume Carteaux |
| collection | DOAJ |
| description | De novo acute hypoxemic respiratory failure (AHRF) remains one of the leading causes of intensive care unit (ICU) admission and is still associated with high rates of intubation and mortality. Developing effective strategies to prevent intubation and its associated complications remains a critical objective in this population. Noninvasive ventilation (NIV) has been proposed as a potential alternative to invasive ventilation in AHRF. However, no clear clinical benefit has been consistently demonstrated to date. The lack of definitive evidence has left experts unable to provide recommendations for the use of NIV in AHRF. Several factors may account for the inconsistencies in the literature and merit further investigation. Identifying early predictive criteria for NIV failure could be essential in determining which patients are most likely to benefit from this intervention. In addition, the approach to NIV settings may require reconsideration, particularly regarding the level of assistance. Efforts to reduce tidal volume, while aiming to minimize ventilator-induced lung injury, may have inadvertently resulted in insufficient support, amplifying the harmful effects of excessive inspiratory effort. The choice of interface may also significantly influence the physiological effects and outcomes and warrants further exploration. Finally, the frugal nature of noninvasive techniques makes them well-suited for the universal management of AHRF, regardless of constraints. This highlights the need for future developments aimed at optimizing oxygen and energy efficiency, enhancing the ease of use and robustness of NIV devices, and evaluating the effectiveness of NIV under high-constraint conditions, such as in low- and middle-income countries. This review addresses these critical questions. |
| format | Article |
| id | doaj-art-f2e8de68f52d423fbad35cec755cbff7 |
| institution | Kabale University |
| issn | 2667-100X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Intensive Medicine |
| spelling | doaj-art-f2e8de68f52d423fbad35cec755cbff72025-08-20T03:29:15ZengElsevierJournal of Intensive Medicine2667-100X2025-07-015323724510.1016/j.jointm.2025.01.001Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future?Guillaume Carteaux0Anne-Fleur Haudebourg1AP-HP, Hôpitaux Universitaires Henri-Mondor, Service de Médecine Intensive Réanimation, 94010, Créteil, France; Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, Créteil 94010, France; INSERM U955, Institut Mondor de Recherche Biomédicale, Créteil 94010 France; Corresponding author: Guillaume Carteaux, CHU Henri Mondor, Service de Médecine Intensive Réanimation, 1, rue Gustave Eiffel, Créteil Cedex 94010, France.AP-HP, Hôpitaux Universitaires Henri-Mondor, Service de Médecine Intensive Réanimation, 94010, Créteil, France; Faculté de Santé, Groupe de Recherche Clinique CARMAS, Université Paris Est-Créteil, Créteil 94010, France; INSERM U955, Institut Mondor de Recherche Biomédicale, Créteil 94010 FranceDe novo acute hypoxemic respiratory failure (AHRF) remains one of the leading causes of intensive care unit (ICU) admission and is still associated with high rates of intubation and mortality. Developing effective strategies to prevent intubation and its associated complications remains a critical objective in this population. Noninvasive ventilation (NIV) has been proposed as a potential alternative to invasive ventilation in AHRF. However, no clear clinical benefit has been consistently demonstrated to date. The lack of definitive evidence has left experts unable to provide recommendations for the use of NIV in AHRF. Several factors may account for the inconsistencies in the literature and merit further investigation. Identifying early predictive criteria for NIV failure could be essential in determining which patients are most likely to benefit from this intervention. In addition, the approach to NIV settings may require reconsideration, particularly regarding the level of assistance. Efforts to reduce tidal volume, while aiming to minimize ventilator-induced lung injury, may have inadvertently resulted in insufficient support, amplifying the harmful effects of excessive inspiratory effort. The choice of interface may also significantly influence the physiological effects and outcomes and warrants further exploration. Finally, the frugal nature of noninvasive techniques makes them well-suited for the universal management of AHRF, regardless of constraints. This highlights the need for future developments aimed at optimizing oxygen and energy efficiency, enhancing the ease of use and robustness of NIV devices, and evaluating the effectiveness of NIV under high-constraint conditions, such as in low- and middle-income countries. This review addresses these critical questions.http://www.sciencedirect.com/science/article/pii/S2667100X25000040Noninvasive ventilationAcute hypoxemic respiratory failurePositive-Pressure Respiration, High-Flow Nasal Cannula, Continuous Positive Airway Pressure (CPAP), Intensive Care Units (ICUs) |
| spellingShingle | Guillaume Carteaux Anne-Fleur Haudebourg Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future? Journal of Intensive Medicine Noninvasive ventilation Acute hypoxemic respiratory failure Positive-Pressure Respiration, High-Flow Nasal Cannula, Continuous Positive Airway Pressure (CPAP), Intensive Care Units (ICUs) |
| title | Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future? |
| title_full | Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future? |
| title_fullStr | Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future? |
| title_full_unstemmed | Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future? |
| title_short | Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future? |
| title_sort | noninvasive ventilation in acute hypoxemic respiratory failure what is the future |
| topic | Noninvasive ventilation Acute hypoxemic respiratory failure Positive-Pressure Respiration, High-Flow Nasal Cannula, Continuous Positive Airway Pressure (CPAP), Intensive Care Units (ICUs) |
| url | http://www.sciencedirect.com/science/article/pii/S2667100X25000040 |
| work_keys_str_mv | AT guillaumecarteaux noninvasiveventilationinacutehypoxemicrespiratoryfailurewhatisthefuture AT annefleurhaudebourg noninvasiveventilationinacutehypoxemicrespiratoryfailurewhatisthefuture |