Respiratory failure & ventilation
Weaning of non chronic obstructive pulmonary disease (COPD) patients at high-risk of extubation failure assessed by lung ultrasound: the WIN IN WEAN multicentre randomised controlled trial
Primary resultResult — go to the resultRelative risk 0.52 CI 0.31–0.88Authors' conclusion
Compared to conventional oxygenation, prophylactic NIV alternating with HFNO significantly reduced postextubation respiratory failure but failed to reduce reintubation rate and mortality in patients without COPD at high risk of extubation failure.
Study context
- Population
- Ventilated non-COPD patients at high risk of postextubation respiratory failure (lung ultrasound score ≥ 14 during the SBT)227 analysed
- Participants
- 240 patients
- Comparison
- Intervention vs Control
- Interventionn = 128
- Controln = 99reference
- Primary endpoint
- Incidence of postextubation respiratory failure (PRF; 2 of: SpO2 < 90%, respiratory rate > 30 /min, hypercapnia, haemodynamic and/or neurological disturbances of respiratory origin)
- Follow-up
- 48 h after extubation
Methodological detailsmulticentre, French-Chinese
- Multicentre
- French-Chinese
Primary result
As reported in the abstract
Relative risk
0.52
CI 0.31–0.88
P = 0.01
Intervention vs Control
RR 0.52 (CI 0.31–0.88); P = 0.01
Secondary outcomes
| Outcome | RR (CI) | P value | |
|---|---|---|---|
| PRF · day 7 | 0.62 (0.44–0.96) | P = 0.02 | |
| 0.512Relative risk (log scale) |
Reintubation avoided with rescue NIV in patients who developed PRF (subgroup)
P = 0.008
Weaning failure imposing reconnection to mechanical ventilation
- Not reduced
Other secondary outcomes (reintubation at day 7, ventilator-free days at day 28, ICU LOS, mortality at day 28 and 90)
- Not different between groups
Resource utilisation
- Prophylactic noninvasive ventilation (NIV) alternating with high-flow nasal oxygen (HFNO) more demanding and costly than conventional oxygen with rescue NIV to achieve same clinical outcome
Original publication
Weaning of non COPD patients at high-risk of extubation failure assessed by lung ultrasound: the WIN IN WEAN multicentre randomised controlled trial. Crit Care. Published 26 November 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →