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- Title
High-Flow Nasal Cannula May Not Reduce the Re-Intubation Rate Compared With a Large-Volume Nebulization-Based Humidifier.
- Authors
Wataru Matsuda; Akiyoshi Hagiwara; Tatsuki Uemura; Takunori Sato; Kentaro Kobayashi; Ryo Sasaki; Tatsuya Okamoto; Akio Kimura
- Abstract
BACKGROUND: High-flow nasal cannula (HFNC) therapy may reduce the re-intubation rate compared with conventional oxygen therapy. However, HFNC has not been sufficiently compared with conventional oxygen therapy with a heated humidifier, even though heated humidification is beneficial for facilitating airway clearance. METHODS: This study was a single-center, open-label, randomized controlled trial. We randomized subjects with respiratory failure after extubation to either HFNC group or to a large-volume humidified nebulization-based nebulizer. The primary end point was the re-intubation rate within 7 d after extubation. RESULTS: We could not recruit enough subjects for the sample size we designed, therefore, we analyzed 69 subjects (HFNC group, 30 subjects; nebulizer group, 39 subjects). The re-intubation rate within 7 d was not significantly different between the HFNC and nebulizer groups (5/30 subjects [17%] and 6/39 subjects [15%], respectively; P > .99). PaO2/set F1O2 at 24 h after extubation was also not significantly different between the respective groups (264 ± 105 mm Hg in the HFNC group vs 224 ± 53 mm Hg in the nebulizer group; P = .07). CONCLUSIONS: Compared with a large-volume nebulization-based humidifier, HFNC may not reduce the re-intubation rate within 7 d. However, because of insufficient statistical power, further studies are needed to reach a conclusion.
- Subjects
JAPAN; APACHE (Disease classification system); FISHER exact test; OXYGEN therapy; RESEARCH funding; RESPIRATORY insufficiency; RESPIRATORY therapy equipment; STATISTICAL sampling; T-test (Statistics); TRACHEA intubation; RANDOMIZED controlled trials; TREATMENT effectiveness; CONTINUING education units; EXTUBATION; DATA analysis software; DESCRIPTIVE statistics; GLASGOW Coma Scale; NASAL cannula
- Publication
Respiratory Care, 2020, Vol 65, Issue 5, p610
- ISSN
0020-1324
- Publication type
Article
- DOI
10.4187/respcare.07095