High-Flow Versus VenturiMask Oxygen Therapy to Prevent Reintubation in Hypoxemic Patients after Extubation: A Multicenter Randomized Clinical Trial

• DOI: 10.1164/rccm.202201-0065oc
• Publication Date: 2022-07-18T19:54:47Z
• Authors: Salvatore Maurizi...; Samir Jaber; Domenico Luca Grieco; Jordi Mancebo; Spyros Zakynthinos; Alexandre Demoule; Jean-Damien Ricard; Paolo Navalesi; Rosanna Vaschetto; Sami Hraiech; Kada Klouche; Jean-Pierre Frat; Virginie Lemiale; Vito Fanelli; Gerald Chanques; Daniele Natalini; Eleni Ischaki; Danielle Reuter; Indalecio Morán; Béatrice La Combe; Federico Longhini; Andrea De Gaetano; V. Marco Ranieri; Laurent J. Brochard; Massimo Antonelli; Yassir Aarab; Elie Azoulay; Fouad Belafia; Guillaume Berquier; Matthieu Conseil; Andrea Costamagna; Laurence Dangers; Audrey De Jong; Julie Delemazure; Francesco Della C...; Ivan Dell’Atti; Stèphane Gaudry; Francesca Grossi; Giovanni Carmine ...; Sylvain Jean-Bapt...; Mohammed Laissi; Romaric Larcher; Matthieu Le Meur; Clèment Leclaire; Paula Andrea Lopez; Sotirios M. Malac...; Marilena Matteo; Julienne Mayaux; Jonathan Messika; Clement Monet; Elise Morawiec; Laurent Papazian; Francisco Parrilla; Laura Platon; Damien Roux; Maria Teresa Sant...; Juan Carlos Suarez; Eloisa Sofia Tanz...; Flavia Toni; Luigi Vetrugno
• Keywords: adverse event; oxygen therapy; Respiratory failure; Acute respiratory failure; hazard ratio; Mechanical ventilation; 0302 clinical medicine; acute respiratory failure; nasal high-flow oxygen; noninvasive ventilation; oxygen therapy; weaning; nasal high-flow oxygen; middle aged; odds ratio; endotracheal intubation; Horowitz index; weaning; adult; clinical trial; 3. Good health; female; Respiratory Insufficiency; Noninvasive ventilation; extubation; 610; Weaning; reintubation; Article; intubation; 03 medical and health sciences; male; Intubation, Intratracheal; Humans; controlled study; human; acute respiratory failure; hypoxemia; Noninvasive Ventilation; respiratory failure; Oxygen Inhalation Therapy; noninvasive ventilation; High-flow nasal oxygen; Oxygen therapy; major clinical study; Oxygen; High-flow nasal oxygen; Mechanical ventilation; Noninvasive ventilation; Respiratory failure; Weaning; multicenter study; confidence interval; randomized controlled trial; treatment outcome; Airway Extubation; [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract; Nasal high-flow oxygen; oxygen; high flow nasal cannula therapy

Rationale: When compared with VenturiMask after extubation, high-flow nasal oxygen provides physiological advantages. Objectives: To establish whether prevents endotracheal reintubation in hypoxemic patients VenturiMask. Methods: In this multicenter randomized trial, 494 exhibiting PaO2:FiO2 ratio ⩽ 300 mm Hg extubation were randomly assigned to receive or oxygen, the possibility apply rescue noninvasive ventilation before reintubation. High-flow use group was not permitted. Measurements and Main Results: The primary outcome rate of within 72 hours according predefined criteria, which validated a posteriori by an independent adjudication committee. secondary outcomes included at 28 days need for criteria. After intubation criteria validation (n = 492 patients), 32 (13%) 27 (11%) required (unadjusted odds ratio, 1.26 [95% confidence interval (CI), 0.70–2.26]; P 0.49). At days, 21% 23% (adjusted hazard 0.89 CI, 0.60–1.31]; 0.55). significantly lower than group: hours, 8% versus 17% 0.39 0.22–0.71]; 0.002) 12% 0.52 0.32–0.83]; 0.007). Conclusions: Reintubation did differ between treated extubation. yielded less frequent ventilation. Clinical trial registered www.clinicaltrials.gov (NCT02107183).