RT Journal Article SR Electronic T1 Effect of Noninvasive Ventilation After Unplanned Extubation JF Respiratory Care FD American Association for Respiratory Care SP respcare.06328 DO 10.4187/respcare.06328 A1 Agathe Kudela A1 Maude Millereux A1 Corentin Gouezel A1 Dominique Prat A1 Frédéric Jacobs A1 Olfa Hamzaoui A1 Nadège Demars A1 Guy Moneger A1 Anne Sylvie Dumenil A1 Pierre Trouiller A1 Benjamin Sztrymf YR 2018 UL http://rc.rcjournal.com/content/early/2018/11/06/respcare.06328.abstract AB BACKGROUND: Our study set out to test the effect of noninvasive ventilation (NIV) performed after unplanned extubation.METHODS: Retrospective analysis of prospectively collected data in a university-affiliated mixed ICU of 12 beds during a 5-y period (January 2013 to December 2017). Unplanned extubation was defined as the occurrence of an unplanned removal of the endotracheal tube, whether deliberate or accidental. NIV after an unplanned extubation was not protocolized and was decided by the physician in charge on an individual basis.RESULTS: A total of 121 subjects (median [25th-75th percentile] age, 62.1 [43.3–73.6] y; median [25th-75th percentile] Simplified Acute Physiology Score II, 45 [36–54]) experienced 131 unplanned extubation episodes. Re-intubation was deemed necessary in 35 subjects (28.9%). NIV was used in 24 subjects (19.8%) (prophylactic NIV, n = 10; rescue NIV, n = 14). The re-intubation rates were 25.8%, 10%, and 64.3% in the no NIV, prophylactic, and rescue NIV subgroups, respectively. The median (25th-75th percentile) time to re-intubation was longer for subjects on NIV (9.1 [3.5–49.2] vs 0.46 [0.25–1] h, P = .001). The median (25th-75th percentile) ICU length of stay and duration of mechanical ventilation were longer in the subjects who underwent NIV (14.5 [7–24.5] vs 6 [3–14] d, respectively, P = .004; and 9 [3–22] vs 3 [1–7.3] d, respectively, P = .003).CONCLUSIONS: NIV after unplanned extubation had uncertain efficacy, especially when provided as rescue management of postextubation respiratory failure.