• Wataru Matsuda, Akiyoshi Hagiwara, Tatsuki Uemura, Takunori Sato, Kentaro Kobayashi, Ryo Sasaki, Tatsuya Okamoto, and Akio Kimura.
• Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan. wmatsuda@hosp.ncgm.go.jp.
• Respir Care. 2020 May 1; 65 (5): 610-617.

BackgroundHigh-flow nasal cannula (HFNC) therapy may reduce the re-intubation rate compared with conventional oxygen therapy. However, HFNC has not been sufficiently compared with conventional oxygen therapy with a heated humidifier, even though heated humidification is beneficial for facilitating airway clearance.MethodsThis study was a single-center, open-label, randomized controlled trial. We randomized subjects with respiratory failure after extubation to either HFNC group or to a large-volume humidified nebulization-based nebulizer. The primary end point was the re-intubation rate within 7 d after extubation.ResultsWe could not recruit enough subjects for the sample size we designed, therefore, we analyzed 69 subjects (HFNC group, 30 subjects; nebulizer group, 39 subjects). The re-intubation rate within 7 d was not significantly different between the HFNC and nebulizer groups (5/30 subjects [17%] and 6/39 subjects [15%], respectively; P > .99). [Formula: see text]/set [Formula: see text] at 24 h after extubation was also not significantly different between the respective groups (264 ± 105 mm Hg in the HFNC group vs 224 ± 53 mm Hg in the nebulizer group; P = .07).ConclusionsCompared with a large-volume nebulization-based humidifier, HFNC may not reduce the re-intubation rate within 7 d. However, because of insufficient statistical power, further studies are needed to reach a conclusion.Copyright © 2020 by Daedalus Enterprises.

28 keywords...

hide…