Comparison of High-Flow Nasal Cannula vs. Conventional Oxygen Therapy in Postextubated Adults

Abstract

Introduction: Postextubation is a critical period for patients transitioning from mechanical ventilation, often associated with risks like respiratory failure, necessitating reintubation. Conventional oxygen therapy (COT), using non-rebreather masks, provides oxygen at limited flow rates, often resulting in discomfort and suboptimal outcomes. High-flow nasal cannula (HFNC) oxygen therapy offers a promising alternative by delivering heated, humidified oxygen at high flow rates, improving oxygenation and comfort.

Objective: This study aims to compare the effects of HFNC and COT on reintubation rates, post-extubation respiratory failure, patient comfort, and length of ICU stay in adult postextubated patients.

Methods: A prospective, randomized comparative study was conducted on patients in the ICU who were extubated after passing a spontaneous breathing trial. A total of 128 patients were divided into two groups: Group H received HFNC therapy, while Group C received COT. Data were collected on reintubation rates within 24 hours, post-extubation respiratory failure, patient comfort, and ICU stay duration.

Results: Group H had significantly lower reintubation rates (0% vs. 17.18%, p<0.001), lower incidence of post-extubation respiratory failure (3.12% vs. 17.18%, p=0.019), and higher patient comfort (98.43% vs. 82.81%, p=0.004) compared to Group C. The mean ICU stay was shorter in Group H (7.73±6.09 days) than Group C (9.05±4.16 days, p<0.001).

Conclusion: HFNC therapy significantly reduces the risk of reintubation, post-extubation respiratory failure, and improves patient comfort compared to conventional oxygen therapy. It also results in a shorter ICU stay, making it a preferable option for respiratory support post-extubation.