Benefit with preventive noninvasive ventilation in subgroups of patients at high-risk for reintubation: a post hoc analysis
Authors
Pablo Sánchez, Raúl De; Hernández Sánchez, Gonzalo; Vaquero, Concepción; Ortiz, Ramón; Colinas, Laura; [et al.]Identifiers
Permanent link (URI): http://hdl.handle.net/10017/59529DOI: 10.1186/s40560-022-00635-2
ISSN: 2052-0492
Date
2022Affiliation
Universidad de Alcalá. Departamento de Medicina y Especialidades Médicas. Unidad Docente de MedicinaBibliographic citation
JOURNAL OF INTENSIVE CARE, 2022, v. 10, n. , p. -
Keywords
High-flow conditioned oxygen therapy
Noninvasive ventilation
Outcome
Postextubation respiratory failure
Reintubation
Weaning
Description / Notes
7 p.
Document type
info:eu-repo/semantics/article
Version
info:eu-repo/semantics/publishedVersion
Rights
© The Author(s) 2022
Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Access rights
info:eu-repo/semantics/openAccess
Abstract
Background: High-fow nasal cannula (HFNC) was shown to be non-inferior to noninvasive ventilation (NIV) for preventing reintubation in a general population of high-risk patients. However, some subgroups of high-risk patients might beneft more from NIV. We aimed to determine whether the presence of many risk factors or overweight (body mass index (BMI)?25 kg/m2 ) patients could have diferent response to any preventive therapy, NIV or HFNC in terms of reduced reintubation rate. Methods: Not pre-specifed post hoc analysis of a multicentre, randomized, controlled, non-inferiority trial compar? ing NFNC and NIV to prevent reintubation in patients at risk for reintubation. The original study included patients with at least 1 risk factor for reintubation. Results: Among 604 included in the original study, 148 had a BMI?25 kg/m2 . When adjusting for potential covari? ates, patients with?4 risk factors (208 patients) presented a higher risk for reintubation (OR 3.4 [95%CI 2.16?5.35]). Patients with?4 risk factors presented lower reintubation rates when treated with preventive NIV (23.9% vs 45.7%; P=0.001). The multivariate analysis of overweight patients, adjusted for covariates, did not present a higher risk for reintubation (OR 1.37 [95%CI 0.82?2.29]). However, those overweight patients presented an increased risk for reintu? bation when treated with preventive HFNC (OR 2.47 [95%CI 1.18?5.15]). Conclusions: Patients with?4 risk factors for reintubation may beneft more from preventive NIV. Based on this result, HFNC may not be the optimal preventive therapy in overweight patients. Specifc trials are needed to confrm these results. Keywords: Weaning, Postextubation respiratory failure, Reintubation, High-fow conditioned oxygen therapy, Noninvasive ventilation, Outcome
Files in this item
Files | Size | Format |
|
---|---|---|---|
benefit_hernandez_JIC_2022.pdf | 915.8Kb |
|
Files | Size | Format |
|
---|---|---|---|
benefit_hernandez_JIC_2022.pdf | 915.8Kb |
|
Collections
- MEDICINA - Artículos [41]