• Ghaida Jabri, Farah Alotaibi, Amjad M Ahmed, Jesna Jose, Farhan Z Alenezi, Musharaf Sadat, Felwa Bin Humaid, Fahad Al-Hameed, Javed Memon, Kasim Al Khatib, Abdullah M Alsuayb, Mohammed AlObaidi, Mohammed Al Mutairi, Ahmad A Alanaizi, Fuad Alghamdi, and Yaseen M Arabi.
• King Saud bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia.
• Respir Care. 2024 Aug 24; 69 (9): 113811451138-1145.

BackgroundThe objective of this study was to evaluate the association between noninvasive ventilation (NIV) compared with invasive ventilation and mortality in subjects with severe acute respiratory infection.MethodsThis was a retrospective multi-center study of subjects with severe acute respiratory infection treated with ventilatory support between September 2012 and June 2018. We compared the 90-d mortality of subjects managed initially with NIV (NIV group) with those managed with invasive ventilation only (invasive ventilation group), adjusting by propensity score.ResultsOf 383 subjects, 189 (49%) were in the NIV group and 194 (51%) were in the invasive ventilation group. Of the subjects initially treated with NIV, 117 (62%) were eventually intubated. Crude 90-d mortality was lower in the NIV group versus the invasive ventilation group (42 [22.2%] vs 77 [39.7%]; P < .001). After propensity score adjustment, NIV was associated with lower 90-d mortality than invasive ventilation (odds ratio 0.54, 95% CI 0.38-0.76; P < .001). The association of NIV with mortality compared with invasive ventilation was not different across the studied subgroups.ConclusionsIn subjects with severe acute respiratory infection and acute respiratory failure, NIV was commonly used. NIV was associated with a lower 90-d mortality. The observed high failure rate suggests the need for further research to optimize patient selection and facilitate early recognition of NIV failure.Copyright © 2024 by Daedalus Enterprises.

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