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Non-invasive therapy might be better for COVID-19 patients, analysis finds

Non-invasive therapy might be better for COVID-19 patients, analysis finds

LONDON – Studies indicate that non-invasive respiratory support (NIRS) for patients with COVID-19 is safe, improves resource utilization and might be associated with better outcomes, according to a new analysis published in The Lancet Respiratory Medicine. 

For the analysis, researchers identified two randomized controlled trials and 83 observational studies compromising 13,931 patients that examined the effects of NIRS modalities—high-flow nasal oxygen, continuous positive airway pressure, and bilevel positive airway pressure—on patients with COVID-19. 

Of 5,120 patients who were candidates for full treatment escalation, 1,880 (37%) progressed to invasive mechanical ventilation and 3,658 of 4669 (78%) survived to study end. Survival was 30% among the 1,050 patients for whom NIRS was the stated ceiling of treatment. 

“The two randomized controlled trials indicate superiority of non-invasive ventilation over high-flow nasal oxygen in reducing the need for intubation,” researchers wrote. 

To guide clinical decision making, prospective, randomized studies are needed to address timing of intervention, optimal use of NIRS modalities—alone or in combination—and validation of tools such as oxygenation indices, response to a trial of NIRS, and inflammatory markers as predictors of treatment success, according to the analysis.


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