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During the past few years, interest has grown in using high-flow oxygen (HFO) and noninvasive positive pressure ventilation (NPPV) in lieu of intubation and mechanical ventilation (NEJM JW Gen Med Aug 1 2015 and JAMA 2015; 313:2331 and N Engl J Med 2015; 372:2185). Two new studies shed light on use of these interventions to prevent reintubation.
In one study, investigators in Spain randomized 527 intensive care unit (ICU) patients with low risk for reintubation to receive either conventional oxygen therapy or HFO after extubation. Oxygen saturation targets were >92% in both groups, and support was maintained for at least 24 hours. Fewer patients in the HFO group than in the conventional group were reintubated within 72 hours (4.9% vs. 12.2%)…