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Comment & Response
May 3, 2016

Noninvasive Ventilation and Outcomes Among Immunocompromised Patients

Author Affiliations
  • 1Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
  • 2Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
  • 3Department of Anesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
JAMA. 2016;315(17):1902. doi:10.1001/jama.2016.0677

To the Editor Dr Lemiale and colleagues1 found that early noninvasive ventilation compared with oxygen therapy alone did not reduce intubation rate and 28-day mortality in immunosuppressed patients with hypoxemic acute respiratory failure. The study has important limitations that the authors acknowledged only in part.

There are at least 3 major methodological limitations in addition to the 2 already recognized by the authors (ie, the lower-than-expected mortality rate, making the study likely underpowered, and the significantly higher proportion of patients receiving high-flow nasal oxygen in the control group, limiting the ability to detect the potential benefit of noninvasive ventilation).2

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