Study
Risk factors for extubation failure
Thille et al. (2011) [3]
Age >65 years or underlying chronic cardiorespiratory disease
Epstein et al. (1997) [50]
Age, APACHE II at time of weaning, and acute respiratory failure of cardiac origin
Frutos-Vivar et al. (2006) [51]
Pneumonia as the reason for intubation, high rapid shallow breathing index (f/VT), and positive fluid balance
Vallverdù et al. (1998) [52]
Neurological patients
Namen et al. (2001) [53]
Rapid shallow breathing index (f/VT) >105, PaO2/FIO2 <200 mmHg, Glasgow Coma Scale score <8
Mokhlesi et al. (2007) [54]
Abundant endotracheal secretions, Glasgow Coma Scale score ≤10, PaCO2 ≥44 mmHg during spontaneous breathing trial
Smina et al. (2003) [55]
Peak expiratory flow ≤60 l/min and rapid shallow breathing index ≥100
Khamiees et al. (2001) [56]
Moderate or abundant endotracheal secretions, cough absent or weak, hemoglobin ≤10 g/dl
Chien et al. (2008) [57]
Increase in B-type natriuretic peptide during a spontaneous breathing trial
Teixeira et al. (2010) [58]
>4.5 % reduction in central venous saturation 30 min after spontaneous breathing trial initiation
Table 13.2
Trials of NIV use for post-extubation respiratory failure
Author | Intervention | Population | Study type | N of patients | Type of ventilation | Interface | Conclusion | |
|---|---|---|---|---|---|---|---|---|
ICU | Jiang et al. (1999) [14] | Preventive | General ICU | RCT | 93 | NPPV | Face mask | No difference in intubation rate |
Keenan et al. (2002) [11] | Treatment | General ICU | RCT | 81 | NPPV | Face mask | No difference in intubation rate | |
Esteban et al. (2004) [12] | Treatment | General ICU | RCT | 221 | NPPV | Face mask | No difference in intubation rate | |
Nava et al. (2005) [13] | Preventive | High-risk | RCT | 97 | NPPV | Face mask | Lower intubation rate in the NPPV group | |
Ferrer et al. (2006) [15] | Preventive | High-risk | RCT | 162 | NPPV | Face mask | Lower incidence of post-extubation respiratory failure in the NPPV group | |
Ferrer et al. (2009) [16] | Preventive | COPD | RCT | 106 | NPPV | Face mask | Lower incidence of post-extubation respiratory failure in the NPPV group | |
Girault et al. (2011) [17] | Preventive | COPD | RCT | 208 | NPPV | Face mask | No difference in intubation rate | |
Khilnani et al. (2011) [18] | Preventive | COPD | RCT | 40 | NPPV | Face mask | No difference in intubation rate | |
Su et al. (2012) [19] | Preventive | General ICU | RCT | 406 | NPPV | Face mask | No difference in intubation rate | |
Postoperative | Varon et al. (1998) [30] | Treatment | Cancer patients | Observational | 60 | NPPV | Face mask | NPPV prevented intubation in 70 % of patients |
Antonelli et al. (2000) [27] | Treatment | Solid organ transplant | RCT | 40 | NPPV | Face mask | Lower intubation rate in the NPPV group | |
Kindgen-Milles et al. (2000) [31] | Treatment | Thoracoabdominal surgery | Observational | 20 | CPAP | Nasal mask | NPPV prevented intubation in 90 % of patients | |
Rocco et al. (2001) [28] | Treatment | Bilateral lung transplant | Observational | 21 | NPPV | Face mask | NPPV prevented intubation in 86 % of patients | |
Auriant et al. (2001) [33] | Treatment | Thoracic surgery | RCT | 48 | NPPV | Nasal mask | Lower intubation rate in the NPPV group | |
Fagevik et al. (2002) [23] | Preventive | Thoracoabdominal surgery | RCT | 70 | CPAP | Face mask | Lower intubation rate in the CPAP group | |
Böhner et al. (2002) [24] | Preventive | Abdominal surgery | RCT | 204 | CPAP | Nasal mask | Lower incidence of post-extubation respiratory failure in the CPAP group | |
Squadrone et al. (2005) [22] | Treatment | Abdominal surgery | RCT | 209 | CPAP | Helmet | Lower intubation rate in the CPAP group | |
Kindgen-Milles et al. (2005) [25] | Preventive | Thoracoabdominal surgery | RCT | 50 | CPAP | Nasal mask | Lower incidence of post-extubation respiratory complications in the CPAP group | |
Zarbock et al. (2009) [26] | Preventive | Cardiac surgery | RCT | 500 | CPAP | Nasal mask | Lower incidence of post-extubation respiratory complications in the CPAP group | |
Wallet et al. (2010) [32] | Treatment | Thoracoabdominal surgery | Observational | 72 | NPPV/CPAP | Facial mask | NPPV/CPAP prevented intubation in 56 % of patients | |
Michelet et al. (2009) [34] | Treatment | Thoracoabdominal surgery | Observational | 36 | NPPV | Face mask | Lower intubation rate in the NPPV group |
References
1.
2.
Changyang L, Yu H, Fan H, Li Z. The efficacy of noninvasive ventilation in managing postextubation respiratory failure: a meta-analysis. Heart Lung J Acute Crit Care. 2014;43:99–104.CrossRef
3.
Thille AW, Harrois A, Schortgen F, Brun-Buisson C, Brochard L. Outcomes of extubation failure in medical intensive care unit patients. Crit Care Med. 2011;39:2612–8.PubMed
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