• Rimoun Hakim, Luis Watanabe-Tejada, Shashvat Sukhal, and Aiman Tulaimat.
• Department of Pulmonary, Critical Care, and Sleep Medicine, Cook County Health, Chicago, IL, United States of America. Electronic address: rimounhakim@gmail.com.
• J Crit Care. 2020 Jun 1; 57: 141-147.

PurposeTo examine the definitions of acute respiratory failure, the characteristics of recruited patients, and the criteria for intubation used in randomized trials.MethodsWe searched MEDLINE for randomized trials of noninvasive respiratory support modalities in patients with de novo respiratory failure. We included trials from 1995 to 2017 that enrolled 40 or more patients and used intubation as an outcome.ResultsWe examined the reports of 53 trials that enrolled 7225 patients. There was wide variation in the use of variables for defining acute respiratory failure. Dyspnea was rarely measured and the increase in breathing effort was poorly defined. The characteristics of patients enrolled in trials changed over time and differed by the cause of respiratory failure. Intubation was poorly characterized. The criteria for intubation had more variables than the criteria for respiratory failure.ConclusionsWe identified deficiencies in the design and reporting of randomized trials, some of which can be remedied by investigators. We also found that patient characteristics differ by the type of respiratory failure. This knowledge can help clinician identify patients at the right moment to benefit from the tested interventions and investigators in developing criteria for enrollment in future trials.Copyright © 2020 Elsevier Inc. All rights reserved.

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