High-flow nasal cannula to prevent postextubation respiratory failure in high-risk non-hypercapnic patients: a randomized multicenter trial

Mostra el registre complet Registre parcial de l'ítem

  • dc.contributor.author Fernández, Rafaelca
  • dc.contributor.author Subira, Carlesca
  • dc.contributor.author Frutos Vivar, Fernandoca
  • dc.contributor.author Rialp, Gemmaca
  • dc.contributor.author Laborda, Cesarca
  • dc.contributor.author Masclans Enviz, Joan Ramonca
  • dc.contributor.author Lesmes, Amandaca
  • dc.contributor.author Panadero, Lunaca
  • dc.contributor.author Hernández, Gonzaloca
  • dc.date.accessioned 2018-03-22T08:39:59Z
  • dc.date.available 2018-03-22T08:39:59Z
  • dc.date.issued 2017
  • dc.description.abstract BACKGROUND: Extubation failure is associated with increased morbidity and mortality, but cannot be safely predicted or avoided. High-flow nasal cannula (HFNC) prevents postextubation respiratory failure in low-risk patients. OBJECTIVE: To demonstrate that HFNC reduces postextubation respiratory failure in high-risk non-hypercapnic patients compared with conventional oxygen. METHODS: Randomized, controlled multicenter trial in patients who passed a spontaneous breathing trial. We enrolled patients meeting criteria for high-risk of failure to randomly receive HFNC or conventional oxygen for 24 h after extubation. Primary outcome was respiratory failure within 72-h postextubation. Secondary outcomes were reintubation, intensive care unit (ICU) and hospital lengths of stay, and mortality. Statistical analysis included multiple logistic regression models. RESULTS: The study was stopped due to low recruitment after 155 patients were enrolled (78 received high-flow and 77 received conventional oxygen). Groups were similar at enrollment, and all patients tolerated 24-h HFNC. Postextubation respiratory failure developed in 16 (20%) HFNC patients and in 21 (27%) conventional patients [OR 0.69 (0.31-1.54), p = 0.2]. Reintubation was needed in 9 (11%) HFNC patients and in 12 (16%) conventional patients [OR 0.71 (0.25-1.95), p = 0.5]. No difference was found in ICU or hospital length of stay, or mortality. Logistic regression models suggested HFNC [OR 0.43 (0.18-0.99), p = 0.04] and cancer [OR 2.87 (1.04-7.91), p = 0.04] may be independently associated with postextubation respiratory failure. CONCLUSION: Our study is inconclusive as to a potential benefit of HFNC over conventional oxygen to prevent occurrence of respiratory failure in non-hypercapnic patients at high risk for extubation failure.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Fernandez R, Subira C, Frutos-Vivar F, Rialp G, Laborda C, Masclans JR et al. High-flow nasal cannula to prevent postextubation respiratory failure in high-risk non-hypercapnic patients: a randomized multicenter trial. Ann Intensive Care. 2017 Dec;7(1):47. DOI: 10.1186/s13613-017-0270-9
  • dc.identifier.doi http://dx.doi.org/10.1186/s13613-017-0270-9
  • dc.identifier.issn 2110-5820
  • dc.identifier.uri http://hdl.handle.net/10230/34234
  • dc.language.iso eng
  • dc.publisher SpringerOpenca
  • dc.relation.ispartof Annals of Intensive Care. 2017 Dec;7(1):47
  • dc.rights Copyright © The Author(s) 2017. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri https://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword High-flow oxygen
  • dc.subject.keyword Mechanical ventilation
  • dc.subject.keyword Reintubation
  • dc.subject.keyword Weaning
  • dc.subject.other Respiració artificial
  • dc.subject.other Insuficiència respiratòria
  • dc.title High-flow nasal cannula to prevent postextubation respiratory failure in high-risk non-hypercapnic patients: a randomized multicenter trialca
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

Col·leccions

Articles (Hospital del Mar Research Institute)
Articles (Departament de Medicina i Ciències de la Vida)