High-flow oxygen following extubation
High-flow oxygen delivered via nasal cannula (HFNC) is being increasingly used in intensive care and high-dependency units since it can deliver high amounts of supplemental oxygen and a small amount of positive expiratory pressure. The efficacy of HFNC following extubation was studied in over 500 patients (mostly postoperative or neurologic) who had been mechanically ventilated for an average of only one to two days and considered at low risk of reintubation [2]. Patients were randomly assigned to conventional low-flow oxygen or HFNC immediately following extubation. HFNC led to a reduction in the rate of reintubation and respiratory failure at 72 hours. These findings suggest that HFNC may be useful in patients who are at low risk for reintubation. However, the results may not apply to other patient populations, since critically ill medical patients and patients at high risk of reintubation were excluded from this study.
2. Hernández G, Vaquero C, González P, et al. Effect of Postextubation High-Flow Nasal Cannula vs Conventional Oxygen Therapy on Reintubation in Low-Risk Patients: A Randomized Clinical Trial. JAMA 2016; 315:1354.