Different oxygenation modalities for early post-extubation: a single center randomized controlled trial
Abstract Background Re-intubation after planned extubation from invasive ventilation is frequently encountered in ICU practice and carries a higher incidence of morbidities and mortalities. We aim to compare high-flow nasal cannula (HFNC) to non-invasive ventilation (NIV) and conventional oxygen the...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Springer
2025-03-01
|
| Series: | Egyptian Journal of Critical Care Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s44349-025-00016-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850039682526609408 |
|---|---|
| author | Walid Omar Ahmed Farouk Mohamed Yasser Sadek Nassar Farouk Mostafa Faris |
| author_facet | Walid Omar Ahmed Farouk Mohamed Yasser Sadek Nassar Farouk Mostafa Faris |
| author_sort | Walid Omar Ahmed |
| collection | DOAJ |
| description | Abstract Background Re-intubation after planned extubation from invasive ventilation is frequently encountered in ICU practice and carries a higher incidence of morbidities and mortalities. We aim to compare high-flow nasal cannula (HFNC) to non-invasive ventilation (NIV) and conventional oxygen therapy (COT) immediately post-extubation from MV and to follow the incidence of reintubation and ICU outcomes. Methods This randomized clinical trial was conducted on 60 patients who were divided equally into 3 different groups according to oxygenation strategy after extubation from invasive MV (HFNC, COT, and NIV groups). The primary outcome was the re-intubation rate, while the secondary outcomes were ICU stay and 28-day mortality. Results The mean age of all patients was 62 ± 20 years, 32 were male, and 21 were smokers. Clinical scores (SOFA and APACHE II), and co-morbidities were matched among the three groups. Both HFNC and NIV (4 patients, 20% in each group) were associated with a significantly lower rate of re-intubation than the COT group (10 patients, 50%) with a p-value < 0.05. The COT group (12.2 ± 6 days) is associated with prolonged ICU stay relative to either HFNC or NIV (8.1 ± 3 or 7.5 ± 3.2) with a p-value of 0.04 for both. ICU and 28-day mortalities were not significantly different among the three groups. Conclusion High-flow nasal cannula and non-invasive mechanical ventilation decreased the rate of re-intubation after successful extubation with better oxygenation and lower ICU stay than conventional oxygen therapy. Trial registration Clinicaltrials.gov [NCT04441736]. |
| format | Article |
| id | doaj-art-e1c522fb550f47dfaa55e8e0c1be1066 |
| institution | DOAJ |
| issn | 2090-7303 2090-9209 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Springer |
| record_format | Article |
| series | Egyptian Journal of Critical Care Medicine |
| spelling | doaj-art-e1c522fb550f47dfaa55e8e0c1be10662025-08-20T02:56:15ZengSpringerEgyptian Journal of Critical Care Medicine2090-73032090-92092025-03-011211910.1007/s44349-025-00016-2Different oxygenation modalities for early post-extubation: a single center randomized controlled trialWalid Omar Ahmed0Farouk Mohamed1Yasser Sadek Nassar2Farouk Mostafa Faris3Department of Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Cairo UniversityAbstract Background Re-intubation after planned extubation from invasive ventilation is frequently encountered in ICU practice and carries a higher incidence of morbidities and mortalities. We aim to compare high-flow nasal cannula (HFNC) to non-invasive ventilation (NIV) and conventional oxygen therapy (COT) immediately post-extubation from MV and to follow the incidence of reintubation and ICU outcomes. Methods This randomized clinical trial was conducted on 60 patients who were divided equally into 3 different groups according to oxygenation strategy after extubation from invasive MV (HFNC, COT, and NIV groups). The primary outcome was the re-intubation rate, while the secondary outcomes were ICU stay and 28-day mortality. Results The mean age of all patients was 62 ± 20 years, 32 were male, and 21 were smokers. Clinical scores (SOFA and APACHE II), and co-morbidities were matched among the three groups. Both HFNC and NIV (4 patients, 20% in each group) were associated with a significantly lower rate of re-intubation than the COT group (10 patients, 50%) with a p-value < 0.05. The COT group (12.2 ± 6 days) is associated with prolonged ICU stay relative to either HFNC or NIV (8.1 ± 3 or 7.5 ± 3.2) with a p-value of 0.04 for both. ICU and 28-day mortalities were not significantly different among the three groups. Conclusion High-flow nasal cannula and non-invasive mechanical ventilation decreased the rate of re-intubation after successful extubation with better oxygenation and lower ICU stay than conventional oxygen therapy. Trial registration Clinicaltrials.gov [NCT04441736].https://doi.org/10.1007/s44349-025-00016-2COTHFNCICUNIVRe-intubation rate |
| spellingShingle | Walid Omar Ahmed Farouk Mohamed Yasser Sadek Nassar Farouk Mostafa Faris Different oxygenation modalities for early post-extubation: a single center randomized controlled trial Egyptian Journal of Critical Care Medicine COT HFNC ICU NIV Re-intubation rate |
| title | Different oxygenation modalities for early post-extubation: a single center randomized controlled trial |
| title_full | Different oxygenation modalities for early post-extubation: a single center randomized controlled trial |
| title_fullStr | Different oxygenation modalities for early post-extubation: a single center randomized controlled trial |
| title_full_unstemmed | Different oxygenation modalities for early post-extubation: a single center randomized controlled trial |
| title_short | Different oxygenation modalities for early post-extubation: a single center randomized controlled trial |
| title_sort | different oxygenation modalities for early post extubation a single center randomized controlled trial |
| topic | COT HFNC ICU NIV Re-intubation rate |
| url | https://doi.org/10.1007/s44349-025-00016-2 |
| work_keys_str_mv | AT walidomarahmed differentoxygenationmodalitiesforearlypostextubationasinglecenterrandomizedcontrolledtrial AT faroukmohamed differentoxygenationmodalitiesforearlypostextubationasinglecenterrandomizedcontrolledtrial AT yassersadeknassar differentoxygenationmodalitiesforearlypostextubationasinglecenterrandomizedcontrolledtrial AT faroukmostafafaris differentoxygenationmodalitiesforearlypostextubationasinglecenterrandomizedcontrolledtrial |