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Respiratory Distress NYD

Date Last Search Run: Mar 03, 2025
Table last updated: Nov 26, 2024
Data last added: Nov 26, 2024

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)    
2 (fair evidence exists)  
3 (weak evidence exists)    


Interventions

High flow nasal cannula
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Major adverse pulmonary events Patient ED-MD Munroe ES, Prevalska I, Hyer M, et al. High-Flow Nasal Cannula Versus Noninvasive Ventilation as Initial Treatment in Acute Hypoxia: A Propensity Score-Matched Study. Crit Care Explor May 2024; 6(5):e1092. Medline
II Neutral (Yellow) Mortality Patient Other Leeies M, Flynn E, Turgeon AF, Paunovic B, Loewen H, Rabbani R, Abou-Setta AM, Ferguson ND, Zarychanski R. High-flow oxygen via nasal cannulae in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis. Syst Rev. 2017 Oct 16;6(1):202. doi: 10.1186/s13643-017-0593-5. PMID: 29037221; PMCID: PMC5644261. Medline
III Supportive (Green) Intubation avoidance Process PH-Paramedic & CCT Das Neves Coelho F, Alves R, Raposo C. Helicopter Air Transport of a Patient Using High Flow Nasal Cannula: A Case Report. Cureus July 2023; 15(7):e41317. Medline
III Neutral (Yellow) Need for mechanical ventilation in the ED Patient ED-MD Jones PG., Kamona S., Doran O., Sawtell F., Wilsher M. Randomized Controlled Trial of Humidified High-Flow Nasal Oxygen for Acute Respiratory Distress in the Emergency Department: The HOT-ER Study. Respir Care 2016; 61(3):291-9. Medline

Intubation
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Mortality Patient PH-Paramedic Stiell IG., et al. Advanced Life Support for Out-of-Hospital Respiratory Distress. NEJM 2007; 356:2156-64. Medline
II Neutral (Yellow) Intubation success, Oxygen saturation Process PH-Paramedic Davis DP., et al. Predictors of intubation success and therapeutic value of paramedic airway management in a large, urban EMS system. Prehosp Emerg Care 2006; 10:356-62. Medline

NiPPV
Level Direction Primary Outcome Patient/Process Setting Reference
I Supportive (Green) Intubation Patient ED-MD Keenan SP., Sinuff T., Cook DJ., Hill NS. Does noninvasive positive pressure ventilation improve outcome in acute hypoxemic respiratory failure? A systematic review. Crit Care Med 2004; 32:2516-23. Medline
I Supportive (Green) Need for tracheal intubation Patient PH-Paramedic Thompson J., Petrie DA., Ackroyd-Stolarz S., Bardua DJ. Out-of-hospital continuous positive pressure ventilation vs usual care in acute respiratory failure: a RCT. Ann Emerg Med 2008; 52(3):232-41. Medline
II Supportive (Green) Feasibility Process PH-Paramedic Fuller GW, Goodacre S, Keating S, Perkins G, Ward M, Rosser A, et al. The ACUTE (Ambulance CPAP: Use, Treatment effect and economics) feasibility study: A pilot randomized controlled trial of prehospital CPAP for acute respiratory failure. Pilot and feasibility studies 2018; 4:86. Medline
II Supportive (Green) Composite of adverse pulmonary events Patient ED-MD Munroe ES, Prevalska I, Hyer M, et al. High-Flow Nasal Cannula Versus Noninvasive Ventilation as Initial Treatment in Acute Hypoxia: A Propensity Score-Matched Study. Crit Care Explor May 2024; 6(5):e1092. Medline
II Supportive (Green) Change in respiratory rate Patient PH-Paramedic Walter DC, Chan HK, Crowe RP, Osborn L, Jarvis J, Wang HE. Out-of-hospital, non-invasive, positive-pressure ventilation for acute dyspnea. J Am Coll Emerg Physicians Open 2021; 2(6):e12542. Medline

Oxygen
Level Direction Primary Outcome Patient/Process Setting Reference

Oxymetry Monitoring
Level Direction Primary Outcome Patient/Process Setting Reference
III Supportive (Green) Detection of hypoxemia Patient PH-Paramedic Bota GW., Rowe BH. Continuous monitoring of oxygen saturation in prehospital patients with severe illness: the problem of unrecognized hypoxemia. J Emerg Med 1995; 13:305-11. Medline

Temperature Monitoring
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Sensitivity and Specificity Process Niven DJ., Gaudet JE., Laupland KB., Mrklas KJ., Roberts DJ., Stelfox HT. Accuracy of Peripheral Thermometers for Estimating Temperature: A Systematic Review and Meta-analysis. Ann Intern Med 2015; 163:768-77. Medline

Transfer of ECMO patients
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Complications Patient PH-MD & CCT Rypulak E, Szczukocka M, Zyzak K, Piwowarczyk P, Borys M, Czuczwar M. Transportation of patients with severe respiratory failure on ECMO support. Four-year experience of a single ECMO center. Anaesthesiology Intensive Therapy 2020; 52(2):91-6. Medline
III Supportive (Green) Survival to receiving facility Patient Other Heuer JF., Mirschel M., Bleckmann A., Quintel M., Moerer O. Interhospital transport of ARDS patients on extracorporeal membrane oxygenation. Journal of artificial organs 2019; 22(1):53-60. Medline
III Neutral (Yellow) 24-hour ECMO survival Patient ED-MD Mihama T, Liem S, Cavarocchi N, Hirose H. Outcomes of out-of-hospital extracorporeal membrane oxygenation transfers: significance of initiation site and personnel. Perfusion 2020; 35(7):633-40. Medline


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