High-flow oxygen therapy through nasal cannulae versus low-flow oxygen therapy via Venturi mask after extubation in adult, critically ill patients

Antonicelli, Federica; Cataldo, Andréa; Festa, Rossano; Idone, Francesco; Moccaldo, A; Antonelli, Massimo; Maggiore, SM

doi:10.1186/cc9585

Cited by 8 publications

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“…Such benefi ts of NIV and HFNCO 2 may be correlated with the similar physiological effects observed when applying CPAP during the early postextubation period. [13][14][15][16] It is unknown whether HFNCO 2 and NIV in combination would impart clear physiological advantages among high-risk patients as assessed by the LUS score. The testing of a targeted therapeutic strategy in a group of high-risk patients defined as having an LUS score ≥14 points at the end of the weaning trial could lead to a reduction in the incidence of extubation failure and associated rates of morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

High-flow nasal cannula oxygen therapy and noninvasive ventilation for preventing extubation failure during weaning from mechanical ventilation assessed by lung ultrasound score: A single-center randomized study

Liu

et al. 2021

World Journal of Emergency Medicine

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BACKGROUND:We sought to demonstrate the superiority of a targeted therapy strategy involving high-fl ow nasal cannula oxygen (HFNCO 2 ) therapy and noninvasive ventilation (NIV) using lung ultrasound score (LUS) in comparison with standard care among patients in the intensive care unit (ICU) who undergo successful weaning to decrease the incidence of extubation failure at both 48 hours and seven days.METHODS: During the study period, 98 patients were enrolled in the study, including 49 in the control group and 49 in the treatment group. Patients in the control group and patients with an LUS score <14 points (at low risk of extubation failure) in the treatment group were extubated and received standard preventive care without NIV or HFNCO 2 . Patients with an LUS score ≥14 points (at high risk of extubation failure) in the treatment group were extubated with a second review of the therapeutic optimization to identify and address any persisting risk factors for postextubation respiratory distress; patients received HFNCO 2 therapy combined with sessions of preventive NIV (4-8 hours per day for 4-8 sessions total) for the fi rst 48 hours after extubation. RESULTS:In the control group, 13 patients had the LUS scores ≥14 points, while 36 patients had scores <14 points. In the treatment group, 16 patients had the LUS scores ≥14 points, while 33 patients had scores <14 points. Among patients with the LUS score ≥14 points, the extubation failure rate within 48 hours was 30.8% in the control group and 12.5% in the treatment group, constituting a statistically signifi cant diff erence (P<0.05). Conversely, among patients with an LUS score <14 points, 13.9% in the control group and 9.1% in the treatment group experienced extubation failure (P=0.61). The length of ICU stay (9.4±3.1 days vs. 7.2±2.4 days) was signifi cantly diff erent and the re-intubation rate (at 48 hours: 18.4% vs. 10.2%; seven days: 22.4% vs. 12.2%) signifi cantly varied between the two groups (P<0.05). There was no signifi cant diff erence in the 28-day mortality rate (6.1% vs. 8.2%) between the control and treatment groups.CONCLUSIONS: Among high-risk adults being weaned from mechanical ventilation and assessed by LUS, the NIV+HFNCO 2 protocol does not lessen the mortality rate but reduce the length of ICU stay, the rate of extubation failure at both 48 hours and seven days.

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Section: Introductionmentioning

confidence: 99%

High-flow nasal cannula oxygen therapy and noninvasive ventilation for preventing extubation failure during weaning from mechanical ventilation assessed by lung ultrasound score: A single-center randomized study

Liu

et al. 2021

World Journal of Emergency Medicine

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“…Also, Antonicelli et al [23], whose study was conducted on 75 postextubated critically ill patients to compare NHF (40 patients on NHF) with VM (35 patients on VM) in ' Agostino-Gemell' University Hospital (Rome, significantly higher in the VM group than in the NHF group. In contrast, there was no significant difference between the two groups with respect to pH, PO 2 , and O 2 saturation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of nasal optiflow device in the management of chronic obstructive pulmonary disease patients with acute excerbations

Saeed¹,

Wagih²,

Hussein³

2015

Egypt J Bronchol

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Background A new form of therapy that provides humidified high-flow oxygen through a nasal cannula has been introduced recently as an alternative in the treatment of spontaneously ventilating patients with high oxygen requirements. Objective The aim of the study was to evaluate the efficacy of a nasal optiflow device in the management of chronic obstructive pulmonary disease (COPD) patients with acute exacerbations in comparison with a conventional venturi mask. Patients and methods Forty-five COPD patients with respiratory failure type II admitted to the RICU at Abbasia Chest Hospital were recruited and divided into two groups: group 1 included 20 randomly selected COPD patients with acute exacerbations connected to a venturi mask; group 2 included 25 randomly selected COPD patients with acute exacerbations connected to nasal high flow (NHF) oxygen with an optiflow system. All patients were subjected to full history taking, thorough clinical examination, and routine laboratory investigations with chest X ray (CXR) and repeated analyses of arterial blood gases (ABGs). Results No statistically significant difference was observed between the two groups with respect to baseline ABG variables (on admission). In both methods (NHF and venturi mask) there was statistically significant improvement in ABG variables in the form of raised pH, PO2, and O2 saturation and reduced PCO2 when compared with baseline ABG values. Although there was no significant difference in weaning results between the two groups, there was significant decline in PCO2 in the NHF group. There was no significant difference in the outcome and end result between the two groups; successful weaning was achieved in 70% of patients in the venturi group and in 64% of the NHF group, whereas failure was reported in 30% of patients in the venturi group and in 36% in the NHF group. Conclusion The nasal optiflow device is highly expensive compared with the venturi mask, although both are approximately equally successful in the treatment of COPD patients with respiratory failure type II.

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“…For the comparison with the standard oxygen therapy group, we included 13 publications, a total of 3440 eligible patients [31,[36][37][38][39][40][41][42][43][44][45][46][47] . Due to the large heterogeneity differences between the literature and the inability to exclude the primary literature that caused the heterogeneity differences after the sensitivity analysis, we chose a random effects model, the results demonstrated that individuals receiving normal oxygen therapy had a higher intervention failure rate than patients in the HFNC group.…”

Section: Failure Of Ventilation (Including Intubation Intubation For ...mentioning

confidence: 99%

Safety and Efficacy of High-flow Nasal Cannula (HFNC) Versus Non-invasive Ventilation in Patients with Respiratory Failure: A Meta-analysis

2024

IJFM

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Respiratory failure can be caused by a variety of diseases and can lead to death due to poor oxygenation. The role of non-invasive respiratory support has been debated. This meta-analysis assesses the effectiveness and reliability of HFNC, standard oxygen (SO) treatment and non-invasive ventilation (NIV) in patients with respiratory failure respectively. The PubMed, Cochrane library, and CNKI databases were systematically searched from the inception dates to March 1, 2022. The primary randomized clinical trials included in meta-analyses were identified. The participants were patients with acute respiratory failure. Hospitalization mortality was defined as the primary outcome. Secondary outcomes were Failure of ventilation, Infection. The PROSPERO database has been registered with this meta-analysis. (registration number: CRD42022320088, 03/26/2022). A total of 26 RCTs involving 6518 patients were included. HFNC did not differ from NIV or SO therapy in terms of hospitalization mortality, ventilation failure, or lung infection. Patients with acute respiratory failure treaded with HFNC were more likely to develop remaining organ failure during hospitalization than those treated with NIV (P = 0.002, I 2 = 0%). Compared to SO, the use of HFNC leads to a more comfortable experience to patients (P=0.0003, I 2 =0%) and increase the oxygen partial pressure (P=0.001, I 2 =0%). In the subgroup analysis results of COVID-19, there were no significant differences between the HFNC, SO, and NIV for intervention failure, hospital mortality and oxygenation index. In hemodynamically stable patients with acute respiratory failure, there was no significant difference in in-hospital mortality and intervention failure rates between HFNC and SO and NIV. HFNC was superior to SO in improving patient oxygen partial pressure and comfort. In addition, there was no significant efficacy difference between NIV and SO for HFNC in the treatment of acute respiratory failure in COVID-19 patients.

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High-flow oxygen therapy through nasal cannulae versus low-flow oxygen therapy via Venturi mask after extubation in adult, critically ill patients

Cited by 8 publications

References 0 publications

High-flow nasal cannula oxygen therapy and noninvasive ventilation for preventing extubation failure during weaning from mechanical ventilation assessed by lung ultrasound score: A single-center randomized study

High-flow nasal cannula oxygen therapy and noninvasive ventilation for preventing extubation failure during weaning from mechanical ventilation assessed by lung ultrasound score: A single-center randomized study

Evaluation of nasal optiflow device in the management of chronic obstructive pulmonary disease patients with acute excerbations

Safety and Efficacy of High-flow Nasal Cannula (HFNC) Versus Non-invasive Ventilation in Patients with Respiratory Failure: A Meta-analysis

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