High flow conditioned oxygen therapy for prevention of reintubation in critically ill patients: a preliminary cohort study
Author
Hernandez, Gonzalo
Vaquero Collado, Concepción
García Plaza, Susana
Villasclaras Pacheco, Ana
Pardo Rey, Candido
De la Fuente O'Connor, Eugenia
Cuena, Rafael
González Arenas, Paloma
Fernández Fernández, Rafael
Publication date
2015-12-31ISSN
2474-3674
Abstract
Objective: To determine the impact of delivering high flow conditioned oxygen therapy (HFO) through nasal cannula on prevention of reintubation in mechanically ventilated (MV) critically ill patients. Design: Prospective cohort sturdy. Setting: General ICU of a university hospital. Patients: all patients under MV > 12-h and after scheduled extubation. Exclusion criteria: hypercapnia at extubation, non-scheduled extubation or with do-not-resuscitate orders. Patients were also divided between low and high reintubation risk. Interventions: From September 2011 to September 2012, all patients received HFO after extubation for a fixed 24-h period and were compared with a historical cohort (2008-2011) treated with conventional oxygen therapy and matched for risk of reintubation. Measurements and Main Results: The primary endpoint was reintubation rate within the 72-h following extubation. Statistical analyses included logistic multivariate model. Main Results: Each cohort included 111 patients with similar clinical characteristics. The HFO group showed a non-significant lower reintubation rate (8.1% vs. 15.3%, p = 0.09). Variables independently related to reintubation rate in the multivariate analysis were HFO (OR 0.31 [0.10-0.95] p = 0.04), hypercapnia after extubation (OR 51.20 [11.55-226.63] p < 0.01), APACHE II > 12 at extubation (OR 1.06 [1.01-1.12] p = 0.04) and length of MV (OR 1.16 [1.03-1.30] p =0.01). The area under the ROC curve for the model was 0.89 (0.77- 0.94). Conclusions: Routine HFO after planned extubation appears to be associated with lower reintubation rate.
Document Type
Article
Document version
Accepted version
Language
English
Subject (CDU)
61 - Medical sciences
Keywords
Respiració artificial
Insuficiència respiratòria
Oxigenoteràpia
Respiración artificial
Insuficiencia respiratoria
Oxigenoterapia
Artificial ventilation
Respiratory failure
Oxygen therapy
Pages
6
Publisher
ClinMed International Library
Collection
1; 2
Is part of
International Journal of Critical Care and Emergency Medicine
Citation
Hernandez, Gonzalo; Vaquero Collado, Concepción; García Plaza, Susana [et al.]. High flow conditioned oxygen therapy for prevention of reintubation in critically ill patients: a preliminary cohort study. International Journal of Critical Care and Emergency Medicine, 2015, vol. 1, núm. 2, p. 1-6. Disponible en: <https://clinmedjournals.org/articles/ijccem/international-journal-of-critical-care-and-emergency-medicine-ijccem-1-009.php?jid=ijccem>. Fecha de acceso: 22 feb. 2020. DOI: 10.23937/2474-3674/1510009
This item appears in the following Collection(s)
- Ciències de la Salut [740]
Rights
© 2015 Hernandez G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/