Fong KM, et al. - Given the risk of life-threatening complications during endotracheal intubation in patients with acute hypoxemic respiratory failure, and the possible utility of preoxygenation in attenuating the risk of hypoxemia and intubation-associated complications, researchers performed this network meta-analysis to evaluate preoxygenation methods with regard to their efficacy and safety in adult patients with acute hypoxemic respiratory failure. They analyzed 7 randomized controlled trials (959 patients) identified from PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials. Significantly less desaturation was observed in patients preoxygenated with noninvasive ventilation (NIV) vs those managed with conventional oxygen therapy (COT) and high-flow nasal cannula (HFNC). Lower risk of intubation-related complications was observed in relation to the use of NIV and HFNC vs COT. Mortality did not significantly differ among the use of NIV, HFNC, COT, and HFNC and NIV during preoxygenation. Overall, findings revealed the safety of NIV as well as possibly the highest efficacy of it among other preoxygenation methods used in adult patients with acute hypoxemic respiratory failure.