%0 Journal Article
%A Jouffroy, Romain
%A Tena, Raquel
%A Vivien, Benoît
%T Noninvasive Airway Management of Comatose Patients With Acute Poisoning
%B JAMA
%D 2024
%R 10.1001/jama.2024.1423
%J JAMA
%V 331
%N 17
%P 1504-1504
%@ 0098-7484
%X To the Editor We read with interest the recent article that reported among comatose patients with suspected acute poisoning, a conservative strategy of withholding intubation was associated with a greater clinical benefit for the composite end point of in-hospital death, length of ICU stay, and length of hospital stay. We think that some methodological issues about this study deserve consideration.First, from a statistical point of view, it is surprising that the median length of mechanical ventilation was null in the restricted intubation group, which included 21 patients who received mechanical ventilation (Table 2 in the article). Second, restriction of the study intervention to the 4 first hours after admission may have been insufficient because it is difficult to predict the maximum intoxication effect, which depends on the time and dose of ingestion, which are often not precisely known. Third, considering the risk of aspiration pneumonia in intoxicated comatose patients, the example of organophosphates presented by the authors is not the most common toxicant reported in daily clinical practice.
%[ 5/20/2024
%U https://doi.org/10.1001/jama.2024.1423