High-flow oxygen therapy for extubation failure prevention in high-risk critically ill patients: a randomized multicenter trial
نویسندگان
چکیده
Introduction Extubation failure in critically ill patients has associated morbidity, but it cannot be safely predicted or avoided. Preventive NIMV has proved beneficial only in hypercapnic patients. We hypothesized that High-flow oxygen therapy may reduce postextubation respiratory failure due to gas humidification, avoidance of lung collapse by moderate PEEP, and work of breathing reduction by dead-space washing.
منابع مشابه
High flow conditioned oxygen therapy for prevention of reintubation in critically ill patients at high risk for extubation failure: a multicenter randomised controlled trial
Introduction Critically ill mechanically ventilated patients are usually stratified in two levels according to the risk for reintubation. In low-risk patients high flow conditioned oxygen therapy (HFO) may reduce reintubation, whereas in high-risk patients non-invasive mechanical ventilation (NIMV) to prevent reintubation is gaining acceptance. However, data on the efficacy or safety of HFO in ...
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In their prospective multicenter randomized controlled trial, Su et al report that noninvasive mechanical ventilation (NIV) used in all patients after extubation did not reduce re-intubation rate, when compared to standard oxygen therapy.1 Nevertheless, we believe that the concept of “preventive” NIV requires not only early application of NIV but also careful selection of patients who are high ...
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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...
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IMPORTANCE Noninvasive ventilation delivered as bilevel positive airway pressure (BiPAP) is often used to avoid reintubation and improve outcomes of patients with hypoxemia after cardiothoracic surgery. High-flow nasal oxygen therapy is increasingly used to improve oxygenation because of its ease of implementation, tolerance, and clinical effectiveness. OBJECTIVE To determine whether high-flo...
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