Respiratory failure & ventilation
Association of prolonged pre-intubation high-flow nasal cannula duration with survival and successful V-V ECMO liberation in severe acute respiratory distress syndrome (ARDS): a retrospective multicenter study
Authors' conclusion
Extended pre-intubation HFNC duration was associated with increased mortality and impaired lung recovery in severe ARDS.
Study context
- Population
- Adults with severe ARDS who received high-flow nasal cannula (HFNC) before V–V ECMO, J-CARVE registry, 2012–2022
- Participants
- 209 adults
- Exposure
- Long vs Short pre-intubation HFNC before V-V ECMO
- Longn = 69
- Outcome
- In-hospital mortality
- Follow-up
- 60 days
Methodological detailsmulticentre registry, multivariable logistic regression, multivariable Cox and Fine-Gray models, exploratory ROC-derived cutoff
- Multicentre registry
- Multivariable logistic regression
- Multivariable Cox and Fine-Gray models
- Exploratory ROC-derived cutoff
Main finding
As reported in the abstract
60-day in-hospital mortality
Estimate (95% CI)P value
HFNC duration, per 1-day increaseHFNC duration analysed continuously
aOR 1.22(1.07–1.39)
P = 0.0035Long vs Short
aHR 2.27(1.24–4.15)
P = 0.008Observational data: associations, not effects.
Further findings
| Outcome | Adjusted Subdistribution Hazard Ratio (95% CI) | P value | |
|---|---|---|---|
| Successful ECMO liberation | 0.68 (0.50–0.94) | P = 0.018 | |
| 0.512Adjusted Subdistribution Hazard Ratio (log scale) |
Original publication
Association of prolonged pre-intubation high-flow nasal cannula duration with survival and successful V-V ECMO liberation in severe ARDS: a retrospective multicenter study. J Intensive Care. Published 29 July 2026. doi:10.
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