{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:18:24Z","timestamp":1790205504230,"version":"4.1.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Efficacy of high-flow nasal cannula (HFNC) over noninvasive ventilation (NIV) in severe coronavirus disease 2019 (COVID-19) pneumonia is not known. We aimed to assess the incidence of invasive mechanical ventilation in patients with acute hypoxemic respiratory failure due to COVID-19 treated with either HFNC or NIV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      This was a single-center randomized controlled trial performed in the COVID-19 ICU of a tertiary care teaching hospital in New Delhi, India. One hundred and nine subjects with severe COVID-19 pneumonia presenting with acute hypoxemic respiratory failure were recruited and allocated to either HFNC (\n                      <jats:italic toggle=\"yes\">n =<\/jats:italic>\n                      55) or NIV (\n                      <jats:italic toggle=\"yes\">n =<\/jats:italic>\n                      54) arm. Primary outcome was intubation by 48 h. Secondary outcomes were improvement in oxygenation by 48 h, intubation rate at day 7, and in-hospital mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics and\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mrow>\n                            <mml:msub>\n                              <mml:mtext mathvariant=\"bold\">P<\/mml:mtext>\n                              <mml:mrow>\n                                <mml:msub>\n                                  <mml:mrow>\n                                    <mml:mtext mathvariant=\"bold\">aO<\/mml:mtext>\n                                  <\/mml:mrow>\n                                  <mml:mtext mathvariant=\"bold\">2<\/mml:mtext>\n                                <\/mml:msub>\n                              <\/mml:mrow>\n                            <\/mml:msub>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      \/\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mrow>\n                            <mml:msub>\n                              <mml:mtext mathvariant=\"bold\">F<\/mml:mtext>\n                              <mml:mrow>\n                                <mml:msub>\n                                  <mml:mrow>\n                                    <mml:mtext mathvariant=\"bold\">IO<\/mml:mtext>\n                                  <\/mml:mrow>\n                                  <mml:mtext mathvariant=\"bold\">2<\/mml:mtext>\n                                <\/mml:msub>\n                              <\/mml:mrow>\n                            <\/mml:msub>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      ratio were similar in both the groups. Intubation rate at 48 h was similar between the groups (33% NIV vs 20% HFNC, relative risk 0.6, 95% CI 0.31\u20131.15,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .12). Intubation rate at day 7 was lower in the HFNC (27.27%) compared to the NIV group (46.29%) (relative risk 0.59, 95% CI 0.35\u20130.99,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .045), and this difference remained significant after adjustment for the incidence of chronic kidney disease and the arterial pH (adjusted OR 0.40, 95% CI 0.17\u20130.93,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03). Hospital mortality was similar between HFNC (29.1%) and NIV (46.2%) group (relative risk 0.6, 95% CI 0.38\u20131.04,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .06).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      We were not able to demonstrate a statistically significant improvement of oxygenation parameters nor of the intubation rate at 48 h between NIV and HFNC. These findings should be further tested in a larger randomized controlled trial. The study was registered at the Clinical Trials Registry of India (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.ctri.nic.in\">www.ctri.nic.in<\/jats:ext-link>\n                      ; reference number: CTRI\/2020\/07\/026835) on July 27, 2020.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.09130","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T14:56:10Z","timestamp":1632840970000},"page":"1824-1830","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":75,"title":["Comparison of High-Flow Nasal Cannula and Noninvasive Ventilation in Acute Hypoxemic Respiratory Failure Due to Severe COVID-19 Pneumonia"],"prefix":"10.1177","volume":"66","author":[{"given":"Parvathy Ramachandran","family":"Nair","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damarla","family":"Haritha","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikant","family":"Behera","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choro Athiphro","family":"Kayina","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souvik","family":"Maitra","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul Kumar","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bikash Ranjan","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Soneja","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeshwari","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalim Kumar","family":"Baidya","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences, New Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6775"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.5394"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30566-3"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-020-00653-z"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503326"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201606-1306OC"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004899"},{"key":"e_1_3_3_9_2","unstructured":"Clinical management of COVID-19: interim guidance. WHO\/2019-nCoV\/clinical\/2020.5. May 27 2020. World Health Organization. https:\/\/apps.who.int\/iris\/handle\/10665\/332196. Accessed May 8 2020."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc8044"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1760-8"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202005-2007LE"},{"key":"e_1_3_3_13_2","article-title":"Use of high-flow nasal cannula and noninvasive ventilation in patients with COVID-19: a multi-center observational study","author":"Duan J","year":"2020","unstructured":"Duan J, , Chen B, , Liu X, , Shu W, , Zhao W, , Li J, et al. Use of high-flow nasal cannula and noninvasive ventilation in patients with COVID-19: a multi-center observational study. Am J Emerg Med, 2020S0735-6757(20)30666-5.","journal-title":"Am J Emerg Med"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02130-2020"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100570"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06033-2"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.09130","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.09130","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.09130","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T08:57:25Z","timestamp":1775465845000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.09130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,28]]},"references-count":15,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.4187\/respcare.09130"],"URL":"https:\/\/doi.org\/10.4187\/respcare.09130","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2021,9,28]]}}}