title: Comparison of the effectiveness of high flow nasal oxygen cannula vs. standard non-rebreather oxygen face mask in post-extubation intensive care unit patients.
abstract: BACKGROUND
  Optimal oxygen supply is the cornerstone of the management of critically ill patients after extubation, especially in patients at high risk for extubation failure. In recent years, high flow oxygen system devices have offered an appropriate alternative to standard oxygen therapy devices such as conventional face masks and nasal prongs.
  
  
  OBJECTIVE
  To assess the clinical effects of high flow nasal cannula (HFNC) compared with standard oxygen face masks in Intensive Care Unit (ICU) patients after extubation.
  
  
  METHODS
  We retrospectively analyzed 67 consecutive ventilated critical care patients in the ICU over a period of 1 year. The patients were allocated to two treatment groups: HFNC (34 patients, group 1) and non-rebreathing oxygen face mask (NRB) (33 patients, group 2). Vital respiratory and hemodynamic parameters were assessed prior to extubation and 6 hours after extubation. The primary clinical outcomes measured were improvement in oxygenation, ventilation-free days, re-intubation, ICU length of stay, and mortality.
  
  
  RESULTS
  The two groups demonstrated similar hemodynamic patterns before and after extubation. The respiratory rate was slightly elevated in both groups after extubation with no differences observed between groups. There were no statistically significant clinical differences in PaCO2. However, the use of HFNC resulted in improved PaO2/FiO2 post-extubation (P < 0.05). There were more ventilator-free days in the HFNC group (P< 0.05) and fewer patients required reintubation (1 vs. 6). There were no differences in ICU length of stay or mortality.
  
  
  CONCLUSIONS
  This study demonstrated better oxygenation for patients treated with HFNC compared with NRB after extubation. HFNC may be more effective than standard oxygen supply devices for oxygenation in the post-extubation period.
authors.affiliation: Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of Negev, Beer Sheva, Israel. bem1975@gmail.com
authors.forename: Evgeni
authors.initials: E
authors.lastname: Brotfain
authors.forename: Alexander
authors.initials: A
authors.lastname: Zlotnik
authors.forename: Andrei
authors.initials: A
authors.lastname: Schwartz
authors.forename: Amit
authors.initials: A
authors.lastname: Frenkel
authors.forename: Leonid
authors.initials: L
authors.lastname: Koyfman
authors.forename: Shaun E
authors.initials: SE
authors.lastname: Gruenbaum
authors.forename: Moti
authors.initials: M
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D060666:Airway Extubation / Q000295:instrumentation* / Q000379:methods; D057785:Catheters; D057186:Comparative Effectiveness Research; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007557:Israel; D007902:Length of Stay; D008297:Male; D008397:Masks; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation / Q000379:methods; D019233:Retreatment / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016019:Survival Analysis; D015300:Ventilator Weaning / Q000295:instrumentation / Q000379:methods