Korean J Intern Med.  2016 Jan;31(1):82-88. 10.3904/kjim.2016.31.1.82.

Clinical efficacy of high-flow nasal cannula compared to noninvasive ventilation in patients with post-extubation respiratory failure

• Yoo JW
• Synn A
• Huh JW
• Hong SB
• Koh Y
• Lim CM

• KMID: 2373776
• DOI: http://doi.org/10.3904/kjim.2016.31.1.82

Abstract

BACKGROUND/AIMS
Post-extubation respiratory failure (PERF) is associated with poor clinica l outcomes. High-f low nasa l cannula (HF NC) ox ygen therapy has been used in patients with respiratory failure, but the clinical benefit in patients with PERF remains unclear. The aim of this study was to evaluate the clinical efficacy of HFNC compared to noninvasive ventilation (NIV) in patients with PERF.
METHODS
A historic retrospective cohort analysis was performed in 28 beds in the medical Intensive Care Unit (ICU) at a single medical center in South Korea. In total, 73 patients with PERF were enrolled: 39 patients who underwent NIV from April 2007 to March 2009 and 34 patients who received HFNC from April 2009 to May 2011.
RESULTS
The rate of avoidance of reintubation was not different between the HFNC group (79.4%) and NIV group (66.7%, p = 0.22). All patients with HFNC tolerated the device, whereas five of those with NIV did not tolerate treatment (p = 0.057). The mean duration of ICU stay was significantly shorter in the HFNC group than in the NIV group (13.4 days vs. 20.6 days, p = 0.015). There was no difference in ICU or in-hospital mortality rate.
CONCLUSIONS
HFNC is likely to be as effective as, and better tolerated than, NIV for treatment of PERF.

Keyword

Post-extubation respiratory failure; Noninvasive ventilation; High-flow nasal cannula

MeSH Terms

Administration, Inhalation
Aged
Airway Extubation/*adverse effects/mortality
*Cannula
Female
Hospital Mortality
Humans
Intensive Care Units
Male
Middle Aged
*Noninvasive Ventilation/adverse effects
Oxygen/*administration & dosage
Oxygen Inhalation Therapy/adverse effects/*instrumentation/mortality
Republic of Korea
Respiratory Insufficiency/diagnosis/etiology/mortality/*therapy
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Oxygen