02783nam a2200325   4500001000800000005001700008007000300025008004100028040000800069041000800077100003700085245007200122300002500194520171600219650003001935650003301965650004101998650003202039650002402071700003102095700003202126700002902158700002802187700002502215700003202240700002702272773011002299942003102409999001702440ESSALUD20260819164758.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aFrat, Jean-Pierre eAutor954172  aHigh-flow or standard oxygen in acute hypoxemic respiratory failure  apáginas: 2095-2106  aBackground: Data are needed on the effect of oxygen delivered through a high-flow nasal cannula, as compared with standard oxygen therapy, on intubation and mortality in patients with acute hypoxemic respiratory failure. Methods: In this multicenter, open-label trial, we randomly assigned patients who had acute hypoxemic respiratory failure to receive high-flow-oxygen or standard-oxygen therapy. All the patients had a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen of 200 or less, a respiratory rate of more than 25 breaths per minute, and pulmonary infiltrate on chest imaging. The primary outcome was death by day 28. Results: A total of 1116 patients underwent randomization. Of these patients, 1110 (556 in the high-flow-oxygen group and 554 in the standard-oxygen group) were included in the analysis. Mortality at day 28 was 14.6% (in 81 of 556 patients) in the high-flow-oxygen group and 14.6% (in 81 of 554 patients) in the standard-oxygen group (difference, −0.05 percentage points; 95% confidence interval [CI], −4.21 to 4.10; P=0.98). The incidence of intubation by day 28 was 42.4% (in 236 of 556 patients) in the high-flow-oxygen group and 48.4% (in 268 of 554 patients) in the standard-oxygen group (difference, −5.93 percentage points; 95% CI, −11.78 to −0.08). Serious adverse events (cardiac arrest or pneumothorax) occurred during spontaneous breathing in 13 patients (2.3%) in the high-flow-oxygen group and in 6 patients (1.1%) in the standard-oxygen group. Conclusions: Among patients with acute hypoxemic respiratory failure, the use of oxygen delivered through a high-flow nasal cannula did not significantly reduce mortality at day 28.   aCUIDADOS INTENSIVOS95208  aMEDICINA DE URGENCIAS953820  aMEDICINA CLINICA HOSPITALARIA953754  aVENTILACION MECANICA937360  aNEUMOLOGÍA925628  aQuenot, Jean-Pierre954173  aGuitton, Christophe 954174  aCoudroy, Rémi  954175  aGacouin, Arnaud 954176  aBadie, Julio 954177  aDemoule, Alexandre  954178  aContou, Damien 9541790 022717922648dMassachusetts NEJM GroupoNEJM011tThe New England Journal of Medicine wESSALUDx0028-4793  cARTICULOSe2026-08-19zsqb  c22834d22834