In Reply As suggested by Dr Frat and colleagues, we cannot rule out that high-flow oxygen undermined the effect of noninvasive ventilation on outcomes. Use of high-flow oxygen may be one advance that accounts for reduced mortality in immunocompromised patients with acute respiratory failure. We agree that before drawing any conclusions, the strengths and weaknesses of high-flow oxygen still need to be appraised in trials dedicated to this specific purpose. In our trial, high-flow oxygen was used in 37% of patients, with no differences in crude mortality rates between patients receiving or not receiving high-flow oxygen (41/141 vs 55/233, P = .24).
Lemiale V, Mokart D, Azoulay E, Groupe de Recherche en Réanimation Respiratoire Onco-Hématologique (GRRR-OH). Noninvasive Ventilation and Outcomes Among Immunocompromised Patients—Reply. JAMA. 2016;315(17):1902-1903. doi:10.1001/jama.2016.0692