Evidence map›Paper›PMID 25851385›Full record

Trial reportIntensive care medicine2015

Direct extubation onto high-flow nasal cannulae post-cardiac surgery versus standard treatment in patients with a BMI ≥30: a randomised controlled trial.

Amanda Corley, Taressa Bull, Amy J Spooner, Adrian G Barnett, John F Fraser

Registry-linked trialAbstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02496923 (A Randomised Controlled Trial of High-flow Nasal Oxygen), which is not on this map. Cited by 69 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 21 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02496923 nacompletednot on this map

A Randomised Controlled Trial of High-flow Nasal Oxygen (Optiflow™) and Standard Oxygen Therapy in High-risk Patients After Cardiac Surgery

TypeinterventionalSponsorPapworth Hospital NHS Foundation TrustRan2015 to 2017Enrolled100ConditionsCardiac SurgeryArmsHigh flow nasal oxygen therapy (Optiflow™), Standard oxygen therapy (Hudson Type face mask or nasal prongs)
3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 21 syntheses or guidelines pooled it.

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  4. Noninvasive respiratory support after extubation: a systematic review and network meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Amanda CorleyCritical Care Research Group, Level 5 CSB, The Prince Charles Hospital, Rode Rd, Chermside, 4032, Australia, amanda.corley@health.qld.gov.au.
Taressa Bull
Amy J Spooner
Adrian G Barnett
John F Fraser

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatients with a body mass index (BMI) ≥30 kg/m(2) experience more severe atelectasis following cardiac surgery than those with normal BMI and its resolution is slower. This study aimed to compare extubation of patients post-cardiac surgery with a BMI ≥30 kg/m(2) onto high-flow nasal cannulae (HFNC) with standard care to determine whether HFNC could assist in minimising post-operative atelectasis and improve respiratory function.

methodsIn this randomised controlled trial, patients received HFNC or standard oxygen therapy post-extubation. The primary outcome was atelectasis on chest X-ray. Secondary outcomes included oxygenation, respiratory rate (RR), subjective dyspnoea, and failure of allocated treatment.

resultsOne hundred and fifty-five patients were randomised, 74 to control, 81 to HFNC. No difference was seen between groups in atelectasis scores on Days 1 or 5 (median scores = 2, p = 0.70 and p = 0.15, respectively). In the 24-h post-extubation, there was no difference in mean PaO2/FiO2 ratio (HFNC 227.9, control 253.3, p = 0.08), or RR (HFNC 17.2, control 16.7, p = 0.17). However, low dyspnoea levels were observed in each group at 8 h post-extubation, median (IQR) scores were 0 (0-1) for control and 1 (0-3) for HFNC (p = 0.008). Five patients failed allocated treatment in the control group compared with three in the treatment group [Odds ratio 0.53, (95 % CI 0.11, 2.24), p = 0.40].

conclusionsIn this study, prophylactic extubation onto HFNC post-cardiac surgery in patients with a BMI ≥30 kg/m(2) did not lead to improvements in respiratory function. Larger studies assessing the role of HFNC in preventing worsening of respiratory function and intubation are required.

Indexed as

Body Mass IndexCathetersAgedAirway ExtubationCardiac Surgical ProceduresFemaleHumansMaleMiddle AgedOxygen Inhalation TherapyPostoperative PeriodPulmonary Atelectasis

Identifiers

PMID25851385

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.