The Comparative Effectiveness of High-Flow Nasal Cannula Therapy Versus Noninvasive Positive Pressure Ventilation in Patients With Acute Hypoxemic Respiratory Failure
Sarfraz, Muhammad Saleem, Asad Hamza Saeed, Muhammad Atta, Maryam Saleem Khan, Mohammad Raja, Sohail K Khan, Rida
Sarfraz, Muhammad
Saleem, Asad
Hamza Saeed, Muhammad
Atta, Maryam
Saleem Khan, Mohammad
Raja, Sohail K
Khan, Rida
Affiliation
Alexandra Hospital Redditch; Bristol Royal Infirmary; The Dudley Group NHS Foundation Trust
Other Contributors
Publication date
2025-07-14
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
This retrospective observational study assessed the comparative effectiveness of high-flow nasal cannula (HFNC) therapy versus noninvasive positive pressure ventilation (NIPPV) in a cohort of 300 patients diagnosed with acute hypoxemic respiratory failure (AHRF). The mean age of the participants was 53.92 years (SD = 22.08), with 55.3% males (n = 166) and a mean BMI of 27.07 kg/m² (SD = 4.85). Patients were nearly evenly distributed between the HFNC (n = 152) and NIPPV (n = 148) groups. Survival was observed in 51.7% (n = 155), with no statistically significant difference between groups. Oxygen saturation improvement was significantly greater in the HFNC group [median SpO₂ = 94%, interquartile range (IQR): 92-96] compared to the NIPPV group (median SpO₂ = 93%, IQR: 91-95; U = 9543.0, p = 0.018). Other metrics, including respiratory rate (HFNC median = 28, NIPPV median = 29; p = 0.207), ICU stay >7 days (28.7%, n = 86), and need for intubation (35.7%, n = 107), did not differ significantly. Multivariate regression showed poor model fit (adjusted R² = -0.017), and logistic regression failed to identify significant survival predictors (χ² = 15.425, df = 17, p = 0.565). These results support HFNC as a viable, potentially superior noninvasive option, particularly for enhancing oxygenation.
Citation
Sarfraz M, Saleem A, Hamza Saeed M, Atta M, Saleem Khan M, Raja SK, Khan R. The Comparative Effectiveness of High-Flow Nasal Cannula Therapy Versus Noninvasive Positive Pressure Ventilation in Patients With Acute Hypoxemic Respiratory Failure. Cureus. 2025 Jul 14;17(7):e87917. doi: 10.7759/cureus.87917
Type
Article