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Post-extubation high-flow oxygen reduces reintubation risk

Patients who underwent high-flow oxygen therapy for 24 hours following extubation had a reduced risk of reintubation and postextubation respiratory failure, according to research.

“Among extubated patients at low risk for reintubation, the use of high-flow nasal cannula oxygen compared with conventional oxygen therapy reduced the risk of reintubation within 72 hours,” Gonzalo Hernández, MD, PhD, from the Department of Critical Care Medicine at Hospital Virgen de la Salud in Madrid, Spain, and colleagues wrote in their study.

Hernández and colleagues evaluated 527 patients at 7 intensive care units in Madrid, Spain, between September 2012 and October 2014 who were in critical care but at a low risk for reintubation, according to the abstract. After extubation, the patients received either high-flow (264 patients) or conventional oxygen therapy (263 patients) for 24 hours. Patients had a mean age of 51 years with a body mass index below 30 and an Acute Physiology and Chronic Health Evaluation II score of less than 12 on the day of extubation.

The researchers found fewer patients in the high-flow group (4.9%; 13 patients) were reintubated within 72 hours compared with patients in the conventional therapy (12.1%; 32 patients) group (absolute difference = 7.2%; 95% CI, 2.5%-12.2%; P = 0.004), according to the abstract. There was also a decreased number of patients with postextubation respiratory failure in the high-flow group (8.3%; 22 patients) compared with the conventional therapy (14.4%; 38 patients) group (absolute difference = 6.1%; 95% CI, 0.7%-11.6%; P = 0.03).

There were no significant differences in either group regarding time to reintubation (absolute difference = −4; 95% CI, −54 to 46; P = 0.66), according to the abstract. The researchers reported no adverse events in either group. – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.