Role of high-flow nasal cannula on patient outcome in postextubation acute hypoxemic respiratory failure

Abstract

High-flow nasal cannula (HFNC) is a type of oxygen support that works better than regular oxygen therapy. It is unclear how well HFNC helps patients after they are taken off the ventilator. This study looks at whether HFNC can reduce the time patients stay in the hospital and the chance they need to be put back on a ventilator after extubation in those with acute hypoxemic respiratory failure (AHRF). This was a clinical trial that included 82 patients who were on a ventilator because of AHRF and met the criteria for discontinuation of ventilator support. Patients were randomly distributed to either HFNC or noninvasive ventilation. Their oxygen levels and vital signs were checked at 2, 4, 6, 12, 24, and 48 h after extubation. The main outcome was how long they stayed in the hospital and the ICU. Participants who used HFNC had lower breathing rates and higher oxygen levels compared with those using noninvasive ventilation at all measured times. They also had shorter hospital and ICU stays, which was a significant result ( P <0.001). However, there was insignificant difference between both groups when it came to the need for re-intubation or death rates. Using HFNC right after extubation in patients with AHRF may help them stay in the hospital and ICU for a shorter time, but it does not change the chances of needing re-intubation or mortality rates.