For immunocompromised patients with acute respiratory failure who are less severe, noninvasive ventilation was shown to be a better treatment option than invasive mechanical ventilation.

“In spite of better antimicrobial agents and preventive measures, infections continue to be one of the most frequent complications in immunocompromised patients and have a high mortality rate of 30% to 90%, with the highest when acute respiratory failure occurs,” Tao Wang, of Peking Union Medical College Hospital in Beijing, China, and colleagues wrote. “Noninvasive mechanical ventilation and invasive mechanical ventilation are two approaches for providing supplemental oxygen for patients with relatively severe acute respiratory failure.”

However, the appropriate choice for relatively severe acute respiratory failure had not been determined.

Wang and colleagues performed a database search and subgroup evaluations on disease severity and causes of immunodeficiency to determine the influence of noninvasive mechanical ventilation compared with invasive mechanical ventilation on clinical outcomes in immunocompromised patients with acute respiratory failure.

The analysis included 2,552 patients from 13 observational studies.

Data indicated that patients treated with noninvasive mechanical ventilation had significantly reduced rates of in-hospital mortality (OR 0.43; 95% CI, 0.23-0.80; P = 0.007), as well as 30-day mortality (OR 0.34; 95% CI, 0.20-0.61; P < 0.0001) compared with those treated with invasive mechanical ventilation.

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