{
    "abstract": "The role of non-invasive respiratory support (high-flow nasal oxygen and noninvasive ventilation) in the management of acute hypoxemic respiratory failure and acute respiratory distress syndrome is debated. The oxygenation improvement coupled with lung and diaphragm protection produced by non-invasive support may help to avoid endotracheal intubation, which prevents the complications of sedation and invasive mechanical ventilation. However, spontaneous breathing in patients with lung injury carries the risk that vigorous inspiratory effort, combined or not with mechanical increases in inspiratory airway pressure, produces high transpulmonary pressure swings and local lung overstretch. This ultimately results in additional lung damage (patient self-inflicted lung injury), so that patients intubated after a trial of noninvasive support are burdened by increased mortality. Reducing inspiratory effort by high-flow nasal oxygen or delivery of sustained positive end-expiratory pressure through the helmet interface may reduce these risks. In this physiology-to-bedside review, we provide an updated overview about the role of noninvasive respiratory support strategies as early treatment of hypoxemic respiratory failure in the intensive care unit. Noninvasive strategies appear safe and effective in mild-to-moderate hypoxemia (PaO",
    "authors": [
        {
            "affiliation": "Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. dlgrieco@outlook.it.\nDepartment of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Fondazione 'Policlinico Universitario A. Gemelli' IRCCS, L.go F. Vito, 00168, Rome, Italy. dlgrieco@outlook.it.",
            "firstname": "Domenico Luca",
            "initials": "DL",
            "lastname": "Grieco"
        },
        {
            "affiliation": "Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy.\nUniversity Department of Innovative Technologies in Medicine and Dentistry, Gabriele D'Annunzio University of Chieti-Pescara, Chieti, Italy.",
            "firstname": "Salvatore Maurizio",
            "initials": "SM",
            "lastname": "Maggiore"
        },
        {
            "affiliation": "Servei de Medicina Intensiva, Hospital Universitari Vall D'Hebron, Institut de Recerca Vall D'Hebron, Barcelona, Spain.\nCiber Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Oriol",
            "initials": "O",
            "lastname": "Roca"
        },
        {
            "affiliation": "Department of Anesthesia, Critical Care and Emergency, Foundation IRCCS Ca' Granda Maggiore Policlinico Hospital, Milan, Italy.",
            "firstname": "Elena",
            "initials": "E",
            "lastname": "Spinelli"
        },
        {
            "affiliation": "Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago, Chicago, IL, USA.",
            "firstname": "Bhakti K",
            "initials": "BK",
            "lastname": "Patel"
        },
        {
            "affiliation": "Centre Hospitalier Universitaire (CHU) de Poitiers, M\u00e9decine Intensive R\u00e9animation, Poitiers, France.\nCentre D'Investigation Clinique 1402, ALIVE, INSERM, Universit\u00e9 de Poitiers, Poitiers, France.",
            "firstname": "Arnaud W",
            "initials": "AW",
            "lastname": "Thille"
        },
        {
            "affiliation": "Division of Pulmonary and Critical Care, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil.\nIntensive Care Unit, Albert Einstein Hospital, S\u00e3o Paulo, Brazil.",
            "firstname": "Carmen S\u00edlvia V",
            "initials": "CSV",
            "lastname": "Barbas"
        },
        {
            "affiliation": "Servei de Medicina Intensiva, Hospital Universitari Vall D'Hebron, Institut de Recerca Vall D'Hebron, Barcelona, Spain.\nDepartament de Medicina, Universitat Aut\u00f2noma de Barcelona, Bellaterra, Spain.",
            "firstname": "Marina Garcia",
            "initials": "MG",
            "lastname": "de Acilu"
        },
        {
            "affiliation": "Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.\nDepartment of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Fondazione 'Policlinico Universitario A. Gemelli' IRCCS, L.go F. Vito, 00168, Rome, Italy.",
            "firstname": "Salvatore Lucio",
            "initials": "SL",
            "lastname": "Cutuli"
        },
        {
            "affiliation": "Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.\nDepartment of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Fondazione 'Policlinico Universitario A. Gemelli' IRCCS, L.go F. Vito, 00168, Rome, Italy.",
            "firstname": "Filippo",
            "initials": "F",
            "lastname": "Bongiovanni"
        },
        {
            "affiliation": "Laborat\u00f3rio de Pneumologia LIM-09, Disciplina de Pneumologia, Heart Institute (Incor), Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil.",
            "firstname": "Marcelo",
            "initials": "M",
            "lastname": "Amato"
        },
        {
            "affiliation": "Centre Hospitalier Universitaire (CHU) de Poitiers, M\u00e9decine Intensive R\u00e9animation, Poitiers, France.\nCentre D'Investigation Clinique 1402, ALIVE, INSERM, Universit\u00e9 de Poitiers, Poitiers, France.",
            "firstname": "Jean-Pierre",
            "initials": "JP",
            "lastname": "Frat"
        },
        {
            "affiliation": "Department of Anesthesia, Critical Care and Emergency, Foundation IRCCS Ca' Granda Maggiore Policlinico Hospital, Milan, Italy.\nDepartment of Pathophysiology and Transplantation, University of Milan, Milan, Italy.",
            "firstname": "Tommaso",
            "initials": "T",
            "lastname": "Mauri"
        },
        {
            "affiliation": "Department of Anesthesia, Critical Care and Emergency, Foundation IRCCS Ca' Granda Maggiore Policlinico Hospital, Milan, Italy.",
            "firstname": "John P",
            "initials": "JP",
            "lastname": "Kress"
        },
        {
            "affiliation": "Servei de Medicina Intensiva, Hospital Universitari de La Santa Creu I Sant Pau, Barcelona, Spain.",
            "firstname": "Jordi",
            "initials": "J",
            "lastname": "Mancebo"
        },
        {
            "affiliation": "Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.\nDepartment of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Fondazione 'Policlinico Universitario A. Gemelli' IRCCS, L.go F. Vito, 00168, Rome, Italy.",
            "firstname": "Massimo",
            "initials": "M",
            "lastname": "Antonelli"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2021. Springer-Verlag GmbH Germany, part of Springer Nature.",
    "doi": "10.1007/s00134-021-06459-2\n10.1001/jama.2016.0291\n10.1007/s00134-020-06245-6\n10.1007/s00134-020-06298-7\n10.1001/jama.2020.3633\n10.1001/jama.2012.5669\n10.1164/rccm.201606-1306OC\n10.1164/rccm.202005-1582LE\n10.1164/rccm.201912-2512OC\n10.1164/rccm.201904-0841OC\n10.1001/jama.2020.9524\n10.1007/s00134-020-06312-y\n10.1183/13993003.02426-2016\n10.1183/13993003.02130-2020\n10.1183/13993003.02130-2020\n10.1007/s00134-020-06294-x\n10.1186/s13054-021-03469-w\n10.1186/s13054-021-03502-y\n10.4187/respcare.08622\n10.1183/13993003.02524-2020\n10.1007/s00134-020-06292-z\n10.1056/NEJM199808133390703\n10.1056/NEJMra1208707\n10.1007/s00134-020-06307-9\n10.1007/s00134-020-06227-8\n10.1001/jama.293.5.589\n10.1164/rccm.200401-042OC\n10.1097/00000542-197501000-00009\n10.1097/00000542-200308000-00019\n10.1097/01.ccm.0000163226.34868.0a\n10.1164/ajrccm.164.1.2001078\n10.1097/MCC.0b013e328342726e\n10.1097/CCM.0b013e3182711972\n10.1097/MCC.0000000000000055\n10.1007/s00134-020-05942-6\n10.1097/CCM.0000000000001379\n10.1097/CCM.0000000000002818\n10.1164/rccm.201604-0748CP\n10.1164/rccm.201605-1081CP\n10.1007/BF00255628\n10.1164/rccm.201303-0539OC\n10.1097/CCM.0000000000001649\n10.1164/rccm.201610-1972OC\n10.1016/j.chest.2016.03.043\n10.1007/s00134-020-06288-9\n10.1016/S2213-2600(18)30366-7\n10.1164/rccm.201503-0620OC\n10.23736/S0375-9393.19.13418-9\n10.1097/MCC.0000000000000691\n10.1164/rccm.201803-0589OC\n10.1007/s00134-012-2475-6\n10.1007/s00134-006-0324-1\n10.1097/CCM.0000000000001359\n10.1172/JCI106015\n10.1113/jphysiol.2006.126466\n10.1164/rccm.201912-2321LE\n10.1164/rccm.202003-0655CP\n10.1097/CCM.0b013e31829e53dc\n10.1097/01.CCM.0000215513.63207.7F\n10.1093/bja/aen094\n10.1017/s0265021503000243\n10.1097/00000542-199212000-00013\n10.1097/CCM.0000000000003649\n10.1164/rccm.201706-1244OC\n10.1113/jphysiol.1914.sp001684\n10.1152/japplphysiol.00753.2009\n10.1001/jama.2021.4682\n10.1007/s00134-020-06228-7\n10.1007/s00134-016-4277-8\n10.4187/respcare.01106\n10.1093/bja/aep280\n10.4187/respcare.02358\n10.1093/bja/aer265\n10.1186/s13613-019-0591-y\n10.1152/japplphysiol.00934.2014\n10.1152/japplphysiol.00584.2016\n10.4187/respcare.03814\n10.1097/CCM.0000000000002693\n10.1164/rccm.201605-0916OC\n10.1007/s00134-011-2354-6\n10.4187/respcare.00801\n10.1111/j.1365-2044.2008.05536.x\n10.1007/s00134-017-4890-1\n10.1056/NEJMoa1503326\n10.1016/S0140-6736(09)60496-7\n10.1001/jama.2016.6338\n10.1164/ajrccm/143.3.469\n10.1164/ajrccm/145.5.1219\n10.1007/s00134-003-1931-8\n10.1097/CCM.0b013e31819b575f\n10.4187/respcare.06635\n10.1164/rccm.200402-226OC\n10.1164/ajrccm.163.2.9906116\n10.1097/CCM.0000000000000819\n10.1001/jama.1984.03350060051030\n10.1186/cc3877\n10.1164/ajrccm.155.2.9032185\n10.1001/jama.284.18.2352\n10.1007/s00134-013-3032-7\n10.1186/s13613-017-0324-z\n10.1007/s00134-002-1208-7\n10.1097/00003246-200203000-00019\n10.1097/01.ccm.0000142577.63316.c0\n10.1007/s00134-012-2686-x\n10.1097/CCM.0b013e31819fff93\n10.1007/s00134-003-1825-9\n10.1007/s00134-008-1109-5\n10.1007/s00134-020-06167-3\n10.1164/rccm.202006-2157CP\n10.1097/01.CCM.0000251821.44259.F3\n10.1007/s00134-001-1114-4\n10.1164/rccm.201804-0726CI\n10.1007/s00540-008-0637-z\n10.1007/s00134-016-4601-3\n10.1038/s41598-019-54020-5\n10.1007/s00134-020-06033-2\n10.1164/rccm.202004-1281LE\n10.1164/ajrccm.160.5.9903015\n10.1164/ajrccm.161.3.9808143\n10.1056/NEJM200102153440703\n10.1164/rccm.200301-072OC\n10.1136/emj.2004.019786\n10.1378/chest.09-1114\n10.1038/bmt.2011.160\n10.1097/CCM.0b013e318232d75e\n10.1001/jama.2015.12402\n10.1186/s13054-019-2575-6\n10.1186/2197-425X-3-S1-A166\n10.1016/j.annemergmed.2017.12.006\n10.1111/1742-6723.12490\n10.4187/respcare.04252\n10.1001/jama.2018.14282\n10.1378/chest.09-2290\n10.1007/s00134-010-1934-1\n10.1007/s00134-014-3325-5",
    "journal": "Intensive care medicine",
    "keywords": [
        "Acute hypoxemic respiratory failure (AHRF)",
        "Acute respiratory distress syndrome (ARDS)",
        "Continuous positive airway pressure (CPAP)",
        "High-flow nasal oxygen (H-FNO)",
        "Inspiratory effort",
        "Noninvasive ventilation (NIV)",
        "Patient self-inflicted lung injury (P-SILI)",
        "Pressure support ventilation (PSV)",
        "Transpulmonary pressure"
    ],
    "methods": null,
    "publication_date": "2021-07-08",
    "pubmed_id": "34232336\n26903337\n32945935\n33123785\n32159735\n22797452\n33334944\n27753501\n32755309\n32325004\n31687831\n32496521\n33201321\n28860265\n32747398\n32747398\n33211135\n33573680\n33627169\n33653913\n33033151\n33175277\n9700176\n24283226\n33170331\n33104824\n15687314\n15201132\n234210\n22672932\n12883410\n1589134\n11435237\n21157317\n23263584\n24335656\n32016537\n26584191\n29099420\n27786562\n27626833\n3230208\n24199628\n27002273\n28212050\n27063348\n33140181\n30455078\n26167730\n30871304\n31815775\n30576221\n22318634\n17019559\n26474112\n5773092\n17412775\n31870169\n32516052\n23982026\n16540958\n18456641\n12622497\n1361310\n30676338\n29323536\n16993311\n19797686\n33764378\n32901374\n26969671\n21496369\n19846404\n23513246\n21908497\n31591659\n25882385\n27856714\n25944940\n28857852\n27997805\n21946925\n21255498\n18540928\n28762180\n25981908\n19616722\n27179847\n2001053\n1586070\n14564379\n26207432\n19237900\n31110031\n16081548\n11179136\n25565461\n6379209\n16356246\n9032185\n11066186\n23928898\n28986852\n11904656\n14982647\n12029267\n11990923\n15483419\n23011529\n19384209\n12802491\n18421436\n32623476\n32539537\n17133177\n11810114\n30199652\n18685924\n27812731\n31754262\n32291463\n32678669\n10556125\n10712326\n11172189\n14500259\n15843697\n19749006\n21927036\n22020236\n26444879\n31484582\n29310868\n26419650\n26577199\n30357270\n20154071\n20533022\n24817030",
    "results": null,
    "title": "Non-invasive ventilatory support and high-flow nasal oxygen as first-line treatment of acute hypoxemic respiratory failure and ARDS.",
    "xml": "<Element 'PubmedArticle' at 0x788504e323e0>"
}