Respiratory failure & ventilation
Long-term outcome of COVID-19 patients treated with helmet noninvasive ventilation vs. high-flow nasal oxygen: a randomized trial
Authors' conclusion
In patients with COVID-19 hypoxemic respiratory failure, treatment with helmet NIV or high-flow oxygen yielded similar quality of life and functional outcome at 6 months.
Study context
- Population
- Patients with COVID-19 hypoxemic respiratory failure alive at 6 months71 (89%) completed follow-up
- Participants
- 80 patients
- Comparison
- Helmet noninvasive ventilation (NIV) vs high-flow nasal oxygen
- Helmet NIVn = 35
- High-flow oxygenn = 36reference
- Primary endpoint
- Clinical status, physical performance (6-min-walking-test, 30-s chair stand test), respiratory function and quality of life (EQ-5D-5L, EQ-VAS, SF36, PTSD Checklist)
- Follow-up
- 6 months
Methodological detailsprespecified analysis
- Prespecified analysis
Primary result
As reported in the abstract
- No inter-group difference in any item of vital signs (N = 4), physical performance (N = 18), respiratory function (N = 27), quality of life (N = 21) and laboratory tests (N = 15)
Further findings
Arthralgia · 6 months
P = 0.002
Diffusing capacity of the lungs for carbon monoxide < 80% of predicted · 6 months
P = 0.44
Forced vital capacity < 80% of predicted · 6 months
P = 0.51
| Outcome | P value |
|---|---|
| Pulmonary function and quality of life: intubated vs avoided invasive mechanical ventilation (subgroup) · 6 monthsIntubated (17/71, 24%) vs Avoided invasive mechanical ventilation (54/71, 76%) · diffusing capacity | P = 0.005 |
| Pulmonary function and quality of life: intubated vs avoided invasive mechanical ventilation (subgroup) · 6 monthsIntubated (17/71, 24%) vs Avoided invasive mechanical ventilation (54/71, 76%) · EQ-VAS | P = 0.01 |
- Pulmonary function and quality of life: intubated vs avoided invasive mechanical ventilation (subgroup): Intubated (17/71, 24%) median 66% (IQR 47–77) % of predicted DLCO · EQ-VAS median [IQR] 70 [53-70]
- Pulmonary function and quality of life: intubated vs avoided invasive mechanical ventilation (subgroup): Avoided invasive mechanical ventilation (54/71, 76%) median 80% (IQR 71–88) % of predicted DLCO · EQ-VAS median [IQR] 80 [70-83]
Pain, anxiety (EQ-5D-5L) and EQ-VAS score · 6 months
- Similar pain (p = 0.81), anxiety (p = 0.81) and EQ-VAS score (p = 0.27) in the two groups
Original publication
Long-term outcome of COVID-19 patients treated with helmet noninvasive ventilation vs. high-flow nasal oxygen: a randomized trial. J Intensive Care. Published 19 May 2023. doi:10.
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