{"id":30470,"date":"2026-03-26T04:07:00","date_gmt":"2026-03-25T20:07:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30470"},"modified":"2026-03-26T05:48:06","modified_gmt":"2026-03-25T21:48:06","slug":"icu-management-practice-%e6%80%a5%e6%80%a7%e4%bd%8e%e6%b0%a7%e8%a1%80%e7%97%87%e6%80%a7%e5%91%bc%e5%90%b8%e5%8a%9f%e8%83%bd%e8%a1%b0%e7%ab%ad%e7%9a%84%e9%ab%98%e6%b5%81%e9%87%8f%e6%b0%a7%e7%96%97","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30470","title":{"rendered":"[ICU Management &#038; Practice]: \u6025\u6027\u4f4e\u6c27\u8840\u75c7\u6027\u547c\u5438\u529f\u80fd\u8870\u7aed\u7684\u9ad8\u6d41\u91cf\u6c27\u7597\u4e0e\u6807\u51c6\u6c27\u7597"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">High-Flow or Standard Oxygen in Acute Hypoxaemic Respiratory Failure<\/h1>\n\n\n\n<ul>\n<li>In&nbsp;<a href=\"https:\/\/healthmanagement.org\/c\/icu\">ICU<\/a><\/li>\n\n\n\n<li>Tue, 17 Mar 2026<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/healthmanagement-org\/image\/upload\/f_auto\/q_90\/fl_lossy\/v1773750021\/cw\/00132248_cw_image_admin_c98de741310f21afc476c7668b15bed7.webp?_a=BAAABnBs\" alt=\"\"\/><\/figure>\n\n\n\n<p>Findings from the SOHO (Standard Oxygen versus High-Flow Oxygen Therapy in Acute Hypoxemic Respiratory Failure) trial were presented @ISICEM this morning.<\/p>\n\n\n\n<p>The SOHO trial compared high-flow nasal oxygen with standard oxygen therapy in adults with acute hypoxaemic respiratory failure. The study addresses an important clinical question: oxygen therapy is the first-line treatment in such patients, and avoiding endotracheal intubation is a key goal because it is associated with complications and increased mortality.<\/p>\n\n\n\n<p>Acute hypoxaemic respiratory failure is a leading cause of ICU admission worldwide, most commonly resulting from viral or bacterial pneumonia. Standard oxygen therapy, typically delivered via a non-rebreather mask, is widely used but has limitations in delivering high fractions of inspired oxygen and reducing the work of breathing. High-flow nasal oxygen, by contrast, can deliver heated, humidified oxygen at high flow rates, improving oxygenation and reducing respiratory effort. Previous studies have suggested that high-flow oxygen may reduce intubation rates and possibly mortality, but evidence has been inconsistent, particularly regarding survival benefits.<\/p>\n\n\n\n<p>The SOHO trial was conducted across 42 ICUs in France and enrolled adult patients with acute hypoxaemic respiratory failure who met specific criteria, including a PaO\u2082:FiO\u2082 ratio of 200 or less, a respiratory rate above 25 breaths per minute, and pulmonary infiltrates on imaging. Patients were randomly assigned in a 1:1 ratio to receive either high-flow oxygen or standard oxygen therapy.<\/p>\n\n\n\n<p>In the high-flow group, oxygen was delivered via nasal cannula at a flow rate of at least 50 litres per minute, with FiO\u2082 adjusted to maintain oxygen saturation between 92% and 96%. In the standard group, oxygen was delivered via a non-rebreather mask at a minimum of 10 litres per minute, with similar oxygen saturation targets. Treatment continued until recovery or intubation, with predefined criteria guiding the decision to intubate.<\/p>\n\n\n\n<p>The primary outcome was mortality at 28 days. Secondary outcomes included the rate of intubation, time to intubation, ventilator-free days, ICU and hospital length of stay, and patient-centred measures such as dyspnoea and respiratory rate.<\/p>\n\n\n\n<p>A total of 1116 patients underwent randomisation, with 1110 included in the final analysis. Baseline characteristics were broadly similar between the two groups. The majority of patients had pneumonia as the underlying cause of respiratory failure, with a large proportion related to viral infections, including COVID-19.<\/p>\n\n\n\n<p>The main finding was that high-flow oxygen did not reduce 28-day mortality compared with standard oxygen therapy. Mortality was identical in both groups at 14.6%, with no statistically significant difference. This indicates that, despite physiological advantages, high-flow oxygen does not confer a survival benefit in this population.<\/p>\n\n\n\n<p>However, differences were observed in secondary outcomes. The incidence of intubation by day 28 was lower in the high-flow group (42.4%) than in the standard oxygen group (48.4%), representing an absolute reduction of nearly 6 percentage points. Although modest, this suggests that high-flow oxygen may help avoid invasive mechanical ventilation in some patients.<\/p>\n\n\n\n<p>High-flow oxygen also showed benefits in early physiological and patient-reported outcomes. Within one hour of treatment initiation, patients in the high-flow group had lower respiratory rates and lower carbon dioxide levels, indicating improved respiratory efficiency. Additionally, a greater proportion of patients reported improvement in dyspnoea compared with those receiving standard oxygen. These findings are consistent with the known physiological effects of high-flow therapy, including reduced work of breathing and improved gas exchange.<\/p>\n\n\n\n<p>Despite these benefits, high-flow oxygen was associated with a slightly higher incidence of certain adverse events, such as pneumothorax, although overall rates were low. Some patients also discontinued therapy due to discomfort, highlighting potential tolerability issues.<\/p>\n\n\n\n<p>In conclusion, the SOHO trial demonstrates that high-flow nasal oxygen does not reduce mortality at 28 days compared with standard oxygen therapy in patients with acute hypoxaemic respiratory failure. However, it may reduce the need for intubation and improve short-term respiratory parameters and patient comfort. Clinicians should consider these factors, along with resource availability and patient preferences, when selecting oxygenation strategies.<\/p>\n\n\n\n<p>Source:&nbsp;<a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2516087\" target=\"_blank\" rel=\"noreferrer noopener\">NEJM<\/a><br \/>Image Credit: iStock<\/p>\n","protected":false},"excerpt":{"rendered":"<p>High-Flow or Standard Oxygen in Acute Hypoxaemic Respir [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30470"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30470"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30470\/revisions"}],"predecessor-version":[{"id":30471,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30470\/revisions\/30471"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30470"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30470"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30470"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}