The purpose of this study is to determine whether high flow nasal cannula is effective in lowering the reintubation rate after extubation for high risk patients in medical intensive care unit
The study hypothesis is that Optiflow may reduce the extubation failure rate for high risk patients in medical intensive care unit.In the intervention group, patients fulfilling inclusion criteria and not presenting any of the exclusion criteria will receive high-flow nasal cannula (Optiflow Airvo2, Fisher \& Paykel Healthcare Ltd., New Zealand) after extubation. The oxygen concentration (FiO2) will be set to reach an oxygenation target similar to control patients (see below), while the gas flow rate will be set at 50 L/min.In the control group, patients fulfilling inclusion criteria and not presenting any of the exclusion criteria will receive standard oxygen therapy including nasal cannula or oxygen mask after extubation. The FiO2 will be set to obtain a arterial oxygen saturation (SpO2) between 92% and 98% (or between 88% and 95% in hypercapnic patients). NIPPV or intubation will be applied in both group if respiratory distress noted. High flow nasal cannula will be tried before NIPPV or intubation in the control group patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
400
High flow nasal cannula used in postextubation patients
Mackay Memorial Hospital
Taipei, Taiwan
RECRUITINGreintubation rate
Time frame: 72 hours after extubation
Need for Non-Invasive Ventilation
Time frame: at day 28 after inclusion in the study
ICU readmission rate due to respiratory failure
Time frame: at day 28 after inclusion in the study
ICU mortality rate
Time frame: at day 28 after inclusion in the study
ICU length of stay
Time frame: at day 28 after inclusion in the study
Hospital mortality
Time frame: at day 28 after inclusion in the study
Hospital length of stay
Time frame: at day 28 after inclusion in the study
Nosocomial pneumonia rate
Time frame: at day 28 after inclusion in the study
Desaturation ( SaO2< 90%)
Time frame: 72 hours after extubation
Severe hypoxemia (PaO2/Fraction of inspired O2 < 200)
Time frame: Time Frame: 72 hours after extubation
hypercapnia (PaCO2 > 50)
Time frame: 72 hours after extubation
respiratory acidosis (arterial pH < 7.30)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: 72 hours after extubation
severe tachypnea (>40/min)
Time frame: 72 hours after extubation