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To the Editor: Dr Antonelli and colleagues¹ report that in patients with acute respiratory failure following solid organ transplantation, noninvasive ventilation (NIV) compared with standard care reduces rates of endotracheal intubation, length of stay in the intensive care unit (ICU), rates of fatal complications, and ICU mortality. In the study, standard care consisted of oxygen supplementation with a Venturi mask. We believe, however, that in patients with postoperative respiratory failure, mere supplementation with oxygen is not adequate care. Especially after major surgery, standard care in patients with respiratory failure also should include lung expansion maneuvers, such as application of continuous positive airway pressure (CPAP) and deep-breathing exercises.² Thus, this study might be interpreted as showing that inadequate care of patients with respiratory failure is harmful.

In our hospital ICU, CPAP is usually applied to patients postoperatively every 4 or 6 hours for 30- to 60-minute intervals or continuously over several . . . [Full Text of this Article]

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Noninvasive Ventilation for Treatment of Acute Respiratory Failure in Patients Undergoing Solid Organ Transplantation: A Randomized Trial
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