Efficacy of High-Flow Nasal Oxygen in Preventing Reintubation in Intensive Care Units: A Comprehensive Review
Abstract
Background: Reintubation in the Intensive Care Unit is one of the most critical challenges that increases morbidity and mortality. HFNO has recently emerged as a new respiratory support modality that was tested to decrease the rate of reintubation; however, its efficacy compared to conventional oxygen therapy and NIV remains debated.
Objective: The aim is to describe the efficacy of HFNO in preventing reintubation for adult ICU patients through a summary of the results from several clinical studies.
Methods: Literature review using PubMed, Cochrane Library, and Google Scholar. Only such publications from 2010 to 2024, related to HFNO postextubation in the ICU, have been included. Randomized controlled trials along with cohort and observational studies that compared HFNO with other respiratory support modalities are the selection criteria for this LDA. Data regarding reintubation rate, patient comfort, and clinical outcomes were extracted and analyzed.
Results: This review shows that HFNO has a lower rate of reintubation and results in a higher degree of patient comfort compared to conventional management with oxygen. The efficacy of HFNO was comparable in high-risk patients with that of NIV; however, the former was better tolerated with fewer complications. Its effectiveness does indeed vary according to patient characteristics, with the severity of respiratory failure and other comorbidities.
Conclusion: HFNO is a valuable treatment strategy for preventing the need for reintubation in select populations of ICU patients. Advantages of HFNO over conventional oxygen therapy include improved patient oxygenation and comfort. However, further research is needed regarding its optimal use, including the identification of specific subgroup patients who would benefit from HFNO..
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