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High-Flow Oxygen Not Inferior for Averting Reintubation

Not inferior to noninvasive mechanical ventilation for high-risk patients who have undergone extubation

man on respirator

FRIDAY, Oct. 7, 2016 (HealthDay News) -- For high-risk critically ill patients who have undergone extubation, high-flow conditioned oxygen therapy is not inferior to noninvasive mechanical ventilation (NIV), according to a study published online Oct. 5 in the Journal of the American Medical Association. The research was published to coincide with the European Society of Intensive Care Medicine Annual Congress, held from Oct. 1 to 5 in Milan.

Gonzalo Hernández, M.D., Ph.D., from the Hospital Virgen de la Salud in Toledo, Spain, and colleagues randomized critically ill patients ready for planned extubation with at least one high-risk factor for reintubation to undergo either high-flow conditioned oxygen therapy or NIV for 24 hours after extubation. Six hundred four patients were enrolled: 314 received NIV and 290 received high-flow oxygen.

The researchers found that 22.8 and 19.1 percent of patients in the high-flow and NIV groups, respectively, did not require reintubation, and 26.9 and 39.8 percent, respectively, experienced post-extubation respiratory failure. There was no significant between-group difference in the median time to reintubation (26.5 and 21.5 hours in the high-flow and NIV groups, respectively). The high-flow group had lower median post-randomization intensive care unit length of stay (three versus four days; P = 0.048). Other secondary outcomes did not differ between the groups.

"Among high-risk adults who have undergone extubation, high-flow conditioned oxygen therapy was not inferior to NIV for preventing reintubation and post-extubation respiratory failure," the authors write.

One author disclosed financial ties to Fisher and Paykel, which provided air-oxygen blenders to two of the study intensive care units.

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