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

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.