PT  - JOURNAL ARTICLE
AU  - Matsuda, Wataru
AU  - Hagiwara, Akiyoshi
AU  - Uemura, Tatsuki
AU  - Sato, Takunori
AU  - Kobayashi, Kentaro
AU  - Sasaki, Ryo
AU  - Okamoto, Tatsuya
AU  - Kimura, Akio
TI  - High-Flow Nasal Cannula May Not Reduce the Re-Intubation Rate Compared With a Large-Volume Nebulization-Based Humidifier
AID  - 10.4187/respcare.07095
DP  - 2020 May 01
TA  - Respiratory Care
PG  - 610--617
VI  - 65
IP  - 5
4099  - http://rc.rcjournal.com/content/65/5/610.short
4100  - http://rc.rcjournal.com/content/65/5/610.full
AB  - BACKGROUND: High-flow nasal cannula (HFNC) therapy may reduce the re-intubation rate compared with conventional oxygen therapy. However, HFNC has not been sufficiently compared with conventional oxygen therapy with a heated humidifier, even though heated humidification is beneficial for facilitating airway clearance.METHODS: This study was a single-center, open-label, randomized controlled trial. We randomized subjects with respiratory failure after extubation to either HFNC group or to a large-volume humidified nebulization-based nebulizer. The primary end point was the re-intubation rate within 7 d after extubation.RESULTS: We could not recruit enough subjects for the sample size we designed, therefore, we analyzed 69 subjects (HFNC group, 30 subjects; nebulizer group, 39 subjects). The re-intubation rate within 7 d was not significantly different between the HFNC and nebulizer groups (5/30 subjects [17%] and 6/39 subjects [15%], respectively; P > .99). /set at 24 h after extubation was also not significantly different between the respective groups (264 ± 105 mm Hg in the HFNC group vs 224 ± 53 mm Hg in the nebulizer group; P = .07).CONCLUSIONS: Compared with a large-volume nebulization-based humidifier, HFNC may not reduce the re-intubation rate within 7 d. However, because of insufficient statistical power, further studies are needed to reach a conclusion.