Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor
To the Editor: Dr Antonelli and colleagues1 report that in patients with acute respiratory
failure following solid organ transplantation, noninvasive ventilation (NIV)
compared with standard care reduces rates of endotracheal intubation, length
of stay in the intensive care unit (ICU), rates of fatal complications, and
ICU mortality. In the study, standard care consisted of oxygen supplementation
with a Venturi mask. We believe, however, that in patients with postoperative
respiratory failure, mere supplementation with oxygen is not adequate care.
Especially after major surgery, standard care in patients with respiratory
failure also should include lung expansion maneuvers, such as application
of continuous positive airway pressure (CPAP) and deep-breathing exercises.2 Thus, this study might be interpreted as showing
that inadequate care of patients with respiratory failure is harmful.
Karzai W, Hüttemann E. Treatment of Postoperative Respiratory Failure. JAMA. 2000;283(17):2239-2240. doi:10.1001/jama.283.17.2235