Noninvasive respiratory supports in ICU

Issued Date

2025-01-01

Resource Type

Review

ISSN

03424642

eISSN

14321238

DOI

10.1007/s00134-025-08036-3

Scopus ID

2-s2.0-105011962328

Journal Title

Intensive Care Medicine

Rights Holder(s)

SCOPUS

Bibliographic Citation

Intensive Care Medicine (2025)

Suggested Citation

Frat J.P., Grieco D.L., De Jong A., Gibbs K., Carteaux G., Roca O., Lemiale V., Piquilloud L., Rittayamai N., Pisani L., Hernandez G., Thille A.W. Noninvasive respiratory supports in ICU. Intensive Care Medicine (2025). doi:10.1007/s00134-025-08036-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/111541

Title

Noninvasive respiratory supports in ICU

Author(s)

Frat J.P.
 Grieco D.L.
 De Jong A.
 Gibbs K.
 Carteaux G.
 Roca O.
 Lemiale V.
 Piquilloud L.
 Rittayamai N.
 Pisani L.
 Hernandez G.
 Thille A.W.

Author's Affiliation

Inserm
 Alma Mater Studiorum Università di Bologna
 Wake Forest University School of Medicine
 Centre Hospitalier Universitaire Vaudois
 Fondazione Policlinico Universitario Agostino Gemelli IRCCS
 Hôpital Henri Mondor
 Hospital Universitari de Bellvitge
 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
 Hospital Universitario Central de Asturias
 Centre Hospitalier Universitaire de Poitiers
 Hôpital Saint Eloi
 Institut Mondor de Recherche Biomédicale
 Faculty of Medicine Siriraj Hospital, Mahidol University
 Université Sorbonne Paris Cité
 Universidad Alfonso X El Sabio
 Faculté de Médecine et de Pharmacie de l'Université de Poitiers
 Grupo de Investigación en Disfunción y Fallo Orgánico en La Agresión (IdiPAZ)
 CRICS-TriggerSEP F-CRIN Research Network

Corresponding Author(s)

Frat J.P.

Other Contributor(s)

Mahidol University

Abstract

Background: Noninvasive respiratory supports are routinely applied in critically ill patients with acute respiratory failure to avoid intubation and invasive mechanical ventilation, thereby reducing the risk of related complications, and to facilitate successful weaning from mechanical ventilation after extubation. They are also applied during the intubation procedure for preoxygenation with the aim of enhancing oxygenation and ensuring the safety of the procedure. Main body: High-flow nasal oxygen decreases airway dead space, provides a stable concentration of inspired oxygen, generates low level of flow-dependent positive airway pressure, and optimizes comfort. Positive-pressure noninvasive supports include continuous positive-airway pressure and noninvasive ventilation and enable providing higher end-expiratory pressure, thereby further improving oxygenation. Noninvasive ventilation, but not continuous positive-airway pressure, better decreases inspiratory effort, and increases tidal volume and transpulmonary driving pressure. Conclusion: High-flow nasal oxygen has become the first-line therapy in acute hypoxemic respiratory failure, while noninvasive ventilation remains the reference treatment during exacerbations of chronic obstructive pulmonary disease, in patients with respiratory acidosis. In patients requiring intubation, noninvasive ventilation is the optimal technique for preoxygenation to decrease the risk of hypoxemia, while high-flow nasal oxygen is an alternative option for non-hypoxemic patients or those with contraindications to noninvasive ventilation. After extubation in patients at high risk of reintubation, prophylactic noninvasive ventilation, eventually alternating with high-flow nasal oxygen, improves weaning outcome compared to other strategies; high-flow nasal oxygen alone outperforms conventional oxygen in low-risk patients.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/123456789/111541

Collections

Scopus 2025