Preventive use of noninvasive ventilation after extubation: A prospective, multicenter randomized controlled trial

Chien-Ling Su, Ling Ling Chiang, Shih Hsing Yang, Hen I. Lin, Kuo-Chen Cheng, Yuh Chin T Huang, Chin Pyng Wu

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

BACKGROUND: The effectiveness of noninvasive ventilation (NIV) after extubation in preventing post-extubation respiratory failure is still controversial. METHODS: We conducted a prospective, multicenter randomized controlled study involving patients on mechanical ventilation for>48 hours who tolerated a 2-hour spontaneous breathing trial and were subsequently extubated. The patients were randomized to NIV or standard medical therapy. Re-intubation rate within 72 hours was the primary outcome measure. Multivariable logistic regression analysis was used to determine predictors for extubation failure. RESULTS: We randomized 406 patients to either NIV (no. = 202) or standard medical therapy (no. = 204). The 2 groups had similar baseline clinical characteristics. There were no differences in extubation failure (13.2% in control and 14.9% in NIV), intensive care unit or hospital mortality. Cardiac failure was a more common cause of extubation failure in control than in NIV. There was no difference in rapid shallow breathing index (RSBI) in extubation failure patients between control (80) and NIV (73). When using data from all patients, we found Acute Physiology and Chronic Health Evaluation (APACHE II) scores (odds ratio [OR] 1.13, 95% CI 1.07-1.20, P

Original languageEnglish
Pages (from-to)204-210
Number of pages7
JournalRespiratory Care
Volume57
Issue number2
DOIs
Publication statusPublished - Feb 2012

Keywords

  • Extubation failure
  • NIV
  • Noninvasive ventilation
  • Re-intubation
  • Weaning failure

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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