The Comparison of Noninvasive Ventilation, High-Flow Oxygen Therapy and Conventional Oxygen Therapy for Weaning Failure in High-Risk Patients

Abstract

Objective: The most common reason for intensive care unit admission is acute respiratory failure and after extubation mainly three methods are used to bring the PaO2 level to a sufficient level: conventional oxygen therapy (COT), high flow oxygen therapy (HFO), and non-invasive ventilation (NIV). The aim of this study was to determine if NIV or HFO is beneficial in decreasing weaning failure in high-risk patient population (HRP) and compare these noninvasive methods. Methods: This prospective, observational cohort study was conducted between March 2019 and March 2020 in a tertiary state hospital in Turkey. Our study included 3 main groups as COT, HFO, and NIV. Results: During the study period, 71 patients were enrolled in this study and 24 patients were in the COT group, 22 HFO group, and 25 in the NIV group. The mean duration of mechanical ventilation assistance (MVA) before extubation was 5.8 days and the mean PaO2 was highest in the HFO group 6 hours after extubation with a statistically significant difference (p<0.001). The HFO group had the highest PaO2/FiO2 immediately before and 6 hours after extubation. The reintubation rate was lowest in the HFO group and the other outcomes as total MVA duration, length of stay in ICU and hospital also differed between groups favoring the HFO group. Conclusion: The results of our study suggest that NIV and HFO were beneficial in decreasing weaning failure and 30-day mortality rate among HRP compared to COT. When these noninvasive methods were compared, it was observed that HFO was preferable because of these advantages although the main characteristics of the groups were different.

High-Flow Nasal Cannula as an Alternate Weaning Strategy: A Randomized Controlled Trial

“…Mungan et al conducted a prospective, observational, cohort study to determine the effects of the use of HFNC, conventional oxygen therapy, and non-invasive ventilation (NIV) on weaning failure in high-risk patients and recorded the lowest re-intubation rate along with a reduced ICU stay and hospital stay in the HFNC group. The study also reported that the total mechanical ventilation assistance duration and length of stay in the ICU and hospital differed between groups receiving NIV, HFNC, and conventional oxygen therapy, thus favoring the high-flow oxygen therapy group [21].…”