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Nasal High-Flowversus Venturi MaskOxygen Therapy afterExtubation. Effectson Oxygenation,Comfort, and ClinicalOutcome Salvatore Maurizio MaggioreFrancesco IdoneRosanna Vaschetto2014 год

Nasal High-Flow versus Venturi Mask Oxygen Therapy after Extubation. Effects on Oxygenation, Comfort, and Clinical Outcome
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Аннотация: Oxygen is commonly administered after extubation. Although several devices are available, data about their clinical efficacy are scarce.To compare the effects of the Venturi mask and the nasal high-flow (NHF) therapy on PaO2/FiO2SET ratio after extubation. Secondary endpoints were to assess effects on patient discomfort, adverse events, and clinical outcomes.Randomized, controlled, open-label trial on 105 patients with a PaO2/FiO2 ratio less than or equal to 300 immediately before extubation. The Venturi mask (n = 52) or NHF (n = 53) were applied for 48 hours postextubation.PaO2/FiO2SET, patient discomfort caused by the interface and by symptoms of airways dryness (on a 10-point numerical rating scale), interface displacements, oxygen desaturations, need for ventilator support, and reintubation were assessed up to 48 hours after extubation. From the 24th hour, PaO2/FiO2SET was higher with the NHF (287 ± 74 vs. 247 ± 81 at 24 h; P = 0.03). Discomfort related both to the interface and to airways dryness was better with NHF (respectively, 2.6 ± 2.2 vs. 5.1 ± 3.3 at 24 h, P = 0.006; 2.2 ± 1.8 vs. 3.7 ± 2.4 at 24 h, P = 0.002). Fewer patients had interface displacements (32% vs. 56%; P = 0.01), oxygen desaturations (40% vs. 75%; P < 0.001), required reintubation (4% vs. 21%; P = 0.01), or any form of ventilator support (7% vs. 35%; P < 0.001) in the NHF group.Compared with the Venturi mask, NHF results in better oxygenation for the same set FiO2 after extubation. Use of NHF is associated with better comfort, fewer desaturations and interface displacements, and a lower reintubation rate. Clinical trial registered with www.clinicaltrials.gov (NCT 01575353).
Год издания: 2014
Авторы: Salvatore Maurizio Maggiore, Francesco Idone, Rosanna Vaschetto, R. Festa, Andrea Cataldo, F Antonicelli, Luca Montini, Andrea De Gaetano, Paolo Navalesi, Massimo Antonelli
Издательство: American Thoracic Society
Источник: American Journal of Respiratory and Critical Care Medicine
Ключевые слова: Respiratory Support and Mechanisms, Airway Management and Intubation Techniques, Neonatal Respiratory Health Research
Другие ссылки: American Journal of Respiratory and Critical Care Medicine (HTML)
PubMed (HTML)