Tuesday December 12, 2006
Noninvasive ventilation to prevent re-intubation !

One study published last year looking into the efficacy of application of noninvasive ventilation in high risk patients to prevent reintubation.

97 consecutive patients requiring mechanical ventilation for more than 48 hours and considered at risk of developing postextubation respiratory failure due to hypercapnia, CHF, ineffective cough, excessive secretions, more than one failure of a weaning trial, more than one comorbid condition etc. were included.

The patients were randomized to receive either noninvasive ventilation (NIV) for about 8 hrs a day in the first 48 hrs or Standard medical treatment (SMT).

NIV group had a lower rate of reintubation 4 of 48 (8.3%) vs. 12 of 49 (24.5%). Also, the use of NIV resulted in a reduction of risk of ICU mortality, mediated by the reduction in the need for reintubation.


Related previous pearl: What is the re-intubation rate in your ICU?



References: Click to get abstract/article

1. Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients - Critical Care Medicine. 33(11):2465-2470, November 2005.