Use of Noninvasive Positive-Pressure Ventilation to Prevent Extubation Failure: A Concise Review

2021 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Extubation Failure ◽  
Positive Pressure ◽  
Concise Review

scholarly journals High-Flow Nasal Cannula versus Noninvasive Positive Pressure Ventilation in Patients with Heart Failure after Extubation: An Observational Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Che-Jung Chang ◽  
Ling-Ling Chiang ◽  
Kuan-Yuan Chen ◽  
Po-Hao Feng ◽  
Chien-Ling Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Treatment Failure ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Extubation Failure ◽  
High Flow ◽  
Positive Pressure ◽  
High Flow Nasal Cannula ◽  
Patients With Heart Failure ◽  
Secondary Outcomes

Noninvasive positive pressure ventilation (NPPV) has been widely applied in patients with high-risk extubation failure, including heart failure. High-flow nasal cannula (HFNC) has been demonstrated to benefit patients with heart failure by reducing cardiac preload. This study aimed to compare the effectiveness of HFNC to NPPV for preventing extubation failure in patients with heart failure. This 3-year retrospective and single-center cohort study included patients with heart failure with left ventricular ejection fraction <50% who received prophylactic HFNC or NPPV after scheduled extubation from January 2015 to January 2018 from a medical center with four adult intensive care units. Demographics, comorbidities, diagnosis, and weaning status were collected. The primary outcome was treatment failure within 72 hours after extubation, which was defined as escalation to NPPV or reintubation in the HFNC group and was defined as requiring reintubation in the NPPV group. Secondary outcomes were reintubation within 72 hours, reintubation, duration of stay, and mortality during the intensive care unit and hospital stay. Of the 104 patients analyzed, characteristics of 58 patients in the HFNC group and 46 patients in the NPPV group were compared. The treatment failure within 72 hours in the two groups was not significantly different (25.9% vs 13%, p=0.106). Hypoxemic respiratory failure related treatment failure was significantly higher in the HFNC group. Prophylactic HFNC as first-line therapy had a comparable rate of reintubation within 72 hours to the prophylactic NPPV alone (17.2% vs 13%, p=0.556). Other secondary outcomes were similar between the two groups. Among patients with heart failure, HFNC was not inferior to NPPV for preventing extubation failure and reintubation. However, in case of an impending respiratory failure, selective patients may benefit from rescue NPPV.

scholarly journals Noninvasive positive-pressure ventilation for extubation failure after cardiac surgery: Pilot safety evaluation

2009 ◽  
Vol 137 (2) ◽  
pp. 342-346 ◽  
Author(s):  
Luca S. De Santo ◽  
Ciro Bancone ◽  
Giuseppe Santarpino ◽  
Gianpaolo Romano ◽  
Alessandro Della Corte ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Safety Evaluation ◽  
Extubation Failure ◽  
Positive Pressure

scholarly journals Comparison of outcomes of high-flow nasal cannula and noninvasive positive-pressure ventilation in patients with hypoxemia and various APACHE II scores after extubation

2021 ◽  
Vol 15 ◽  
pp. 175346662110042
Author(s):  
Xiaoke Shang ◽  
Yanggan Wang
Keyword(s):  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Abdominal Distension ◽  
Apache Ii ◽  
Positive Pressure ◽  
Apache Ii Score ◽  
Subgroup Ii ◽  
Significant Difference ◽  
Group A ◽  
Group B

Aims: The study aimed to compare and analyze the outcomes of high-flow nasal cannula (HFNC) and noninvasive positive-pressure ventilation (NPPV) in the treatment of patients with acute hypoxemic respiratory failure (AHRF) who had extubation after weaning from mechanical ventilation. Methods: A total 120 patients with AHRF were enrolled into this study. These patients underwent tracheal intubation and mechanical ventilation. They were organized into two groups according to the score of Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II); group A: APACHE II score <12; group B: 12⩽ APACHE II score <24. Group A had 72 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (36 patients in each subgroup). Group B had 48 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (24 patients in each subgroup). General information, respiratory parameters, endpoint event, and comorbidities of adverse effect were compared and analyzed between the two subgroups. Results: The incidence of abdominal distension was significantly higher in patients treated with NPPV than in those treated with HFNC in group A (19.44% versus 0, p = 0.005) and group B (25% versus 0, p = 0.009). There was no significant difference between the HFNC- and NPPV-treated patients in blood pH, oxygenation index, partial pressure of carbon dioxide, respiratory rate, and blood lactic acid concentration in either group ( p > 0.05). Occurrence rate of re-intubation within 72 h of extubation was slightly, but not significantly, higher in NPPV-treated patients ( p > 0.05). Conclusion: There was no significant difference between HFNC and NPPV in preventing respiratory failure in patients with AHRF with an APACHE II score <24 after extubation. However, HFNC was superior to NPPV with less incidence of abdominal distension. The reviews of this paper are available via the supplemental material section.

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