For the management of immunocompromised ICU patients with acute hypoxemic respiratory failure, noninvasive ventilation (NIV) is not superior to oxygen therapy alone, according to research published in JAMA.

NIV is commonly used in immunocompromised patients, although without strong evidence of efficacy in reducing mortality.

Investigators from France studied a total of 374 immunocompromised adult patients who were randomly assigned to receive NIV or oxygen therapy alone. The 28-day mortality was 24.1% in the NIV group and 27.3% in the oxygen group, and oxygenation failure occurred in 38.2% of the NIV group and 44.8% of the oxygen therapy group.

There were no significant between-group differences in rate of ICU-acquired infections, duration of mechanical ventilation, or length of ICU or hospital stay.

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