About: High-flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease patients after extubation: a multicenter, randomized controlled trial

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About: High-flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease patients after extubation: a multicenter, randomized controlled trial Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	High-flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease patients after extubation: a multicenter, randomized controlled trial
Creator	Xu, Jun Xu, Yan Tan, Dingyu Cao, Peng Geng, Ping Harold Walline, Joseph Ling, Bingyu Shan, Xueqin Sun, Jiayan Wang, Bingxia Wang, Yunyun Zhu, Qingcheng
Source	PMC
abstract	BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy is being increasingly used to prevent post-extubation hypoxemic respiratory failure and reintubation. However, evidence to support the use of HFNC in chronic obstructive pulmonary disease (COPD) patients with hypercapnic respiratory failure after extubation is limited. This study was conducted to test if HFNC is non-inferior to non-invasive ventilation (NIV) in preventing post-extubation treatment failure in COPD patients previously intubated for hypercapnic respiratory failure. METHODS: COPD patients with hypercapnic respiratory failure who were already receiving invasive ventilation were randomized to HFNC or NIV at extubation at two large tertiary academic teaching hospitals. The primary endpoint was treatment failure, defined as either resumption of invasive ventilation or switching to the other study treatment modality (NIV for patients in the NFNC group or vice versa). RESULTS: Ninety-six patients were randomly assigned to the HFNC group or NIV group. After secondary exclusion, 44 patients in the HFNC group and 42 patients in the NIV group were included in the analysis. The treatment failure rate in the HFNC group was 22.7% and 28.6% in the NIV group—risk difference of − 5.8% (95% CI, − 23.8–12.4%, p = 0.535), which was significantly lower than the non-inferior margin of 9%. Analysis of the causes of treatment failure showed that treatment intolerance in the HFNC group was significantly lower than that in the NIV group, with a risk difference of − 50.0% (95% CI, − 74.6 to − 12.9%, p = 0.015). One hour after extubation, the mean respiratory rates of both groups were faster than their baseline levels before extubation (p < 0.050). Twenty-four hours after extubation, the respiratory rate of the HFNC group had returned to baseline, but the NIV group was still higher than the baseline. Forty-eight hours after extubation, the respiratory rates of both groups were not significantly different from the baseline. The average number of daily airway care interventions in the NIV group was 7 (5–9.3), which was significantly higher than 6 (4–7) times in the HFNC group (p = 0.006). The comfort score and incidence of nasal and facial skin breakdown of the HFNC group was also significantly better than that of the NIV group [7 (6–8) vs 5 (4–7), P < 0.001] and [0 vs 9.6%, p = 0.027], respectively. CONCLUSION: Among COPD patients with severe hypercapnic respiratory failure who received invasive ventilation, the use of HFNC after extubation did not result in increased rates of treatment failure compared with NIV. HFNC also had better tolerance and comfort than NIV. TRIAL REGISTRATION: chictr.org (ChiCTR1800018530). Registered on 22 September 2018, http://www.chictr.org.cn/usercenter.aspx
has issue date	2020-08-06(xsd:dateTime)
bibo:doi	10.1186/s13054-020-03214-9
has license	cc-by
sha1sum (hex)	e2f07f10bfee522ac2e7cccee0fec95e3d7c2110
schema:url	https://doi.org/10.1186/s13054-020-03214-9
resource representing a document's title	High-flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease patients after extubation: a multicenter, randomized controlled trial
has PubMed Central identifier	PMC7407427
schema:publication	Crit Care
resource representing a document's body	covid:e2f07f10bfee522ac2e7cccee0fec95e3d7c2110#body_text
is schema:about of	named entity 'COPD' named entity 'respiratory failure' named entity 'extubation' named entity 'EXTUBATION' named entity 'non-invasive ventilation' named entity 'However' named entity 'NIV' named entity 'oxygen therapy' named entity 'respiratory failure' named entity 'hypercapnic' named entity 'non-invasive ventilation' named entity 'respiratory failure' named entity 'chronic obstructive pulmonary disease' named entity 'nasal cannula' named entity 'invasive mechanical ventilation' named entity 'Non-invasive ventilation' named entity 'extubation' named entity 'NIV' named entity 'Physiology' named entity 'Friedman test' named entity 'HFNC' named entity 'dyspnea' named entity 'hypercapnic' named entity 'respiratory support' named entity 'infection control' named entity 'invasive ventilation' named entity 'risk difference' named entity 'HFNC' named entity 'Respiratory rate' named entity 'chronic obstructive pulmonary disease' named entity 'COPD' named entity 'informed consent' named entity '95% CI' named entity 'respiratory failure' named entity 'invasive ventilation' named entity 'extubation' named entity '37°C' named entity 'nasal prongs' named entity 'alveolar ventilation' named entity 'Chronic Health' named entity 'consciousness' named entity 'respiratory rate' named entity 'arterial blood gas' named entity 'HFNC' named entity 'alveolar ventilation' named entity 'sputum' named entity 'hemodynamic' named entity 'NIV' named entity 'COPD' named entity 'Auckland' named entity 'data analysis' named entity 'extubation' named entity 'skin breakdown' named entity 'invasive ventilation' named entity 'NIV' named entity 'NIV' named entity '95% CI' named entity 'intubation' named entity 'comorbidities' named entity 'extubation' named entity 'NIV' named entity 'COPD' named entity 'humidity' named entity 'respiratory rate' named entity 'respiratory frequency' named entity 'extubation' named entity 'skin breakdown' named entity 'NIV' named entity 'HFNC' named entity 'mixed gases' named entity 'BiPap' named entity 'analysis of variance'

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