AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |
Back to Blog
Hfnc oxygen1/13/2024 ![]() The median numbers of high-risk factors for reintubation in the NIPPV and HFNC groups were 5.0 (interquartile range : 4–6) and 4.5 (IQR: 4–6), respectively. Most of the patients were recruited from the medical ICU (85% in both groups). Approximately half of the patients were male (65% and 50% in the NIPPV and HFNC groups, respectively). The mean ages of the NIPPV and HFNC groups were 74 ± 13 and 75 ± 11 years, respectively. We conducted the present study to compare the effectiveness of HFNC and NIPPV in preventing reintubation among patients receiving PMV.Ī total of 40 patients were enrolled and assigned to the NIPPV and HFNC groups, with 20 patients in each group (see Supplementary Fig. However, to the best of our knowledge, the effectiveness of HFNC and NIPPV in preventing reintubation among patients receiving PMV have remained inconclusive. ![]() A large-scale randomized controlled trial (RCT) reported that HFNC was noninferior to NIPPV for preventing reintubation and postextubation respiratory failure in patients at high risk of extubation failure 21. ![]() Postextubation oxygen therapy with a HFNC has benefits for patients with acute hypoxemic respiratory failure 20. A high-flow nasal cannula (HFNC) can deliver up to 60 L/min of warm gas flow with adequate humidification (relative humidity of nearly 100%) 18, 19. High-flow oxygen therapy can be administered using a nasal cannula 16 or through a tracheostomy 17. Two meta-analyses revealed that early application of NIPPV can reduce reintubation rates however, a subgroup analysis focusing on patients at high risk of reintubation has not yet been fully investigated 14, 15. A systematic review revealed that as a weaning strategy, NIPPV has advantages over invasive ventilation, including lower rates of weaning failure, reintubation, and mortality, and that the benefits of NIPPV for mortality were significantly greater in studies enrolling only patients with chronic obstructive pulmonary disease (COPD) 13. After extubation, NIPPV can be immediately applied as an early weaning strategy 9, 10, routinely applied for all patients at high risk of reintubation 11, or applied for patients who develop respiratory distress 12. Noninvasive positive pressure ventilation (NIPPV) is widely used as a preventive measure against reintubation among high-risk populations, including patients with heart failure or obstructive lung diseases 8. Because of the high mortality rate associated with reintubation, postextubation respiratory management is crucial, especially for high-risk populations 7. PMV is associated with increased risks of reintubation 3 and mortality 3, 4, 5, 6. This rate can even exceed 20% among patients with risk factors, including age more than 65 years, an underlying chronic cardiac or lung disease, and prolonged mechanical ventilation (PMV) 1, 2. Trial registration: ( ).Īpproximately 10–15% of intensive care unit (ICU) patients who undergo endotracheal extubation experience extubation failure and require reintubation 1. Additional studies evaluating HFNC as an alternative to NIPPV for patients receiving PMV are warranted.Ĭ ID: NCT04564859 IRB number: 20160901R. Although HFNC is becoming increasingly common as a form of postextubation NRS, HFNC may not be as effective as NIPPV in preventing reintubation among patients who have been receiving PMV for at least 2 weeks. The time to event outcome analysis also revealed that the risk of reintubation in the HFNC group was higher than that in the NIPPV group ( P = 0.018). No significant differences in length of RCC stay, length of hospital stay, time to liberation from NRS, and ventilator-free days at 28-day were identified. two patients, respectively) did not differ significantly. ![]() The 90-day mortality rates of the NIPPV and HFNC groups (four patients vs. None of the patients in the NIPPV group required reintubation, whereas 5 (25%) of the patients in the HFNC group required reintubation ( P = 0.047). The primary outcome was reintubation within7 days after extubation. Participants were randomized to an HFNC group or an NIPPV group (20 patients in each) and received noninvasive respiratory support (NRS) administered using their assigned method. This single-center, prospective, unblinded randomized controlled trial was at the respiratory care center (RCC). We conducted the present study to compare the effectiveness of oxygen therapy administered using high-flow nasal cannulae (HFNC) and noninvasive positive pressure ventilation (NIPPV) in preventing reintubation among patients receiving prolonged mechanical ventilation (PMV). Because of the high mortality rate associated with reintubation, postextubation respiratory management is crucial, especially for high-risk populations. Many intensive care unit patients who undergo endotracheal extubation experience extubation failure and require reintubation. ![]()
0 Comments
Read More
Leave a Reply. |