Arnaud W. The combination of high-flow nasal oxygen with noninvasive ventilation NIV may be an optimal strategy of ventilation to avoid reintubation. The reintubation rate at day 7 was Among the 11 prespecified secondary outcomes, 6 showed no significant difference. Corresponding Author: Arnaud W.
Section Editor: Derek C. Although noninvasive ventilation may prevent postextubation respiratory failure in patients at high risk, only 2 small-scale randomized clini- cal trials RCTs have shown decreased reintubation rates com- pared with standard oxygen. This multicenter RCT involving patients at high risk of ex- tubation failure in the ICU was conducted to determine whether high-flow nasal oxygen with noninvasive ventilation, com- pared with high-flow nasal oxygen alone, after extubation could reduce the rate of reintubation.
Question Among mechanically ventilated patients at high risk of extubation failure, does the use of high-flow nasal oxygen with noninvasive ventilation after extubation reduce the risk of reintubation compared with high-flow nasal oxygen alone? Findings In this randomized clinical trial that included patients, high-flow nasal oxygen with noninvasive ventilation, compared with high-flow nasal oxygen alone, significantly decreased the rate of reintubation within the first 7 days after extubation Meaning In patients at high risk of extubation failure, the use of high-flow nasal oxygen with noninvasive ventilation after extubation significantly decreased the risk of reintubation compared with high-flow nasal oxygen alone.
No safety committee was required because the interventions used in the study were strategies of oxygenation typically used in clinical practice. Research assistants regularly monitored all the centers on site to check adherence to the protocol and the accuracy of the data recorded.
An investigator at each center was responsible for daily patient screening, enrolling pa- tients in the study, ensuring adherence to the protocol, and completing the electronic case-report form.
