Respiratory failure & ventilation
Prophylactic noninvasive ventilation after extubation in high-risk patients without hypercapnia
Authors' conclusion
For high-risk patients, but without hypercapnia on the day of extubation, the use of prophylactic NIV alternating with HFNC after extubation significantly decreases the risk of reintubation as compared to HFNC alone.
Study context
- Population
- High-risk patients (>65 years or underlying cardiac/respiratory disease) without hypercapnia (PaCO2 ≤ 45 mmHg) on the day of extubation
- Participants
- 829 patients
- Comparison
- Prophylactic noninvasive ventilation (NIV) alternating with high-flow nasal cannula (HFNC) vs HFNC alone after extubation
- NIV + HFNCn = 540
- HFNC alonen = 289reference
- Primary endpoint
- Proportion of patients requiring reintubation
- Follow-up
- Within seven days following extubation
Methodological detailsG-computation
- G-computation
Primary result
As reported in the abstract
Reintubation · day 7
Difference
- 5.8%
95% CI - 11.2 to −0.8%P = 0.021
Reintubation
Estimated difference (G-computation)
- 5.6%
95% CI - 11.0 to - 0.5%
marginal causal effect
Further findings
Reintubation at 48 h, 72 h and until ICU discharge
- Significantly lower with NIV + HFNC than HFNC alone at 48 h, 72 h and until ICU discharge
Original publication
Prophylactic noninvasive ventilation after extubation in high-risk patients without hypercapnia. Intensive Care Med. Published 13 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →