Early non-invasive ventilation and high-flow nasal oxygen therapy for preventing endotracheal intubation in hypoxemic blunt chest trauma patients: the OptiTHO randomized trial
Primary resultResult — go to the resultAdjusted odds ratio 0.72 95% CI 0.20–2.43- stopped for futility
- Enrollment stopped for futility after a 2-year study period
Authors' conclusion
A prompt association of HFNC-O2 with preventive NIV did not reduce the rate of endotracheal intubation or secondary respiratory complications when compared to COT and late NIV in high-risk blunt chest trauma patients with non-severe hypoxemia and no sign of acute respiratory failure.
Study context
- Population
- Adult ICU patients within 48 h of high-risk blunt chest trauma (Thoracic Trauma Severity Score ≥ 8), estimated PaO2/FiO2 < 300, no acute respiratory failurerandomised
- Participants
- 141 patients
- Comparison
- Early HFNC-O2 plus early non-invasive ventilation (NIV) vs standard care
- Experimentaln = 71
- Controln = 70reference
- Primary endpoint
- Endotracheal intubation for delayed respiratory failure
Methodological detailsopen-label, multicentre
- Open-label
- Multicentre
Primary result
As reported in the abstract
Adjusted odds ratio
0.72
95% CI 0.20–2.43
P = 0.60
Events by treatment group
Experimental vs Control
aOR 0.72 (95% CI 0.20–2.43); P = 0.60
Secondary outcomes
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Pulmonary infection | 1.99 (0.73–5.89) | P = 0.18 | |
| Delayed hemothorax | 0.85 (0.33–2.20) | P = 0.74 | |
| Delayed ARDS | 2.14 (0.36–20.77) | P = 0.41 | |
| 0.050.21520Adjusted odds ratio (log scale) |
Original publication
Early non-invasive ventilation and high-flow nasal oxygen therapy for preventing endotracheal intubation in hypoxemic blunt chest trauma patients: the OptiTHO randomized trial. Crit Care. Published 26 April 2023. doi:10.
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