A Retrospective Study of Short-term versus Long-term Use of High Flow Nasal Cannula after Extubation in the Intensive Care Unit

Isr Med Assoc J. 2020 Mar;22(3):173-177.

Abstract

Background: The use of a high flow nasal cannula (HFNC) was examined for different clinical indications in the critically ill.

Objectives: To describe a single center experience with HFNC in post-extubation critical care patients by using clinical indices.

Methods: In this single center study, the authors retrospectively evaluated the outcome of patients who were connected to the HFNC after their extubation in the intensive care unit (ICU). At 48 hours after the extubation, the patients were divided into three groups: the group weaned from HFNC, the ongoing HFNC group, and the already intubated group.

Results: Of the 80 patients who were included, 42 patients were without HFNC support at 48 hours after extubation, 22 and 16 patients were with ongoing HFNC support and already intubated by this time frame, respectively. The mean ROX index (the ratio of SpO2 divided by fraction of inspired oxygen to respiratory rate) at 6 hours of the weaned group was 12.3 versus 9.3 in the ongoing HFNC group, and 8.5 in the reintubated group (P = 0.02). The groups were significantly different by the ICU length of stay, tracheostomy rate, and mortality.

Conclusions: Among patients treated with HFNC post-extubation of those who had a higher ROX index were less likely to undergo reintubation.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Airway Extubation*
  • Cannula
  • Critical Care / methods*
  • Critical Illness
  • Female
  • Humans
  • Intensive Care Units
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Oxygen Inhalation Therapy / instrumentation
  • Oxygen Inhalation Therapy / methods*
  • Oxygen Inhalation Therapy / statistics & numerical data*
  • Respiratory Insufficiency / therapy*
  • Retrospective Studies
  • Time
  • Young Adult