Trial reportIntensive care medicine2022
Effect of postextubation noninvasive ventilation with active humidification vs high-flow nasal cannula on reintubation in patients at very high risk for extubation failure: a randomized trial.
Trial report in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06301035 (Comparison of Asymmetric High-flow Nasal Cannula), which is not on this map. Cited by 56 papers, 5 of them syntheses that pooled 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.
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.
Comparison of Asymmetric High-flow Nasal Cannula (HFNC) and Standard HFNC in Post Extubation High-risk Group: A Prospective, Single-center, Open-labeled, Randomized Controlled Pilot Study
Who cites it
56 citing papers in PubMed, 5 syntheses or guidelines pooled it, 121 citations in OpenAlex.
- High-Flow Nasal Cannula Versus Noninvasive Ventilation for Prevention of Reintubation in High-Risk Critically Ill Patients (HIGH-FLOW OXY): An Informative Systematic Review and Meta-Analysis.Critical care explorations · 2026Pooled it
- The efficacy of high-flow nasal cannula versus non-invasive mechanical ventilation in preventing reintubation in patients at high risk of extubation failure: systematic review and meta-analysis with trial sequential analysis.Critical care science · 2026Pooled it
- Effect of a short period of invasive mechanical ventilation following a successful spontaneous breathing trial in adults: a systematic review and meta-analysis.Critical care science · 2026Pooled it
- Risk prediction models for extubation failure in critically ill patients on mechanical ventilation: a systematic review.Frontiers in medicine · 2025Pooled it
- Pooled it
- Use of rescue noninvasive ventilation for post-extubation respiratory failure.Critical care (London, England) · 2025Trial
- Noninvasive ventilation in postoperative critically ill patients with morbid obesity: secondary analysis of the EXTUBOBESE multicentre randomised clinical trial.British journal of anaesthesia · 2025Trial
- Physiological comparison of noninvasive ventilation and high-flow nasal oxygen on inspiratory efforts and tidal volumes after extubation: a randomized crossover trial.Critical care (London, England) · 2025Trial
- Weaning of non COPD patients at high-risk of extubation failure assessed by lung ultrasound: the WIN IN WEAN multicentre randomised controlled trial.Critical care (London, England) · 2024Trial
- Noninvasive ventilation on reintubation in patients with obesity and hypoxemic respiratory failure following abdominal surgery: a post hoc analysis of a randomized clinical trial.Intensive care medicine · 2024Trial
- Effect of Reintubation Within 48 Hours on Mortality in Critically Ill Patients After Planned Extubation.Respiratory care · 2024Trial
- Effect of aggressive vs conservative screening and confirmatory test on time to extubation among patients at low or intermediate risk: a randomized clinical trial.Intensive care medicine · 2024Trial
- Effectiveness of high-flow nasal cannulae compared with noninvasive positive-pressure ventilation in preventing reintubation in patients receiving prolonged mechanical ventilation.Scientific reports · 2023Trial
- High-flow nasal cannula oxygen during breaks from noninvasive ventilation after extubation: an observational study.Intensive care medicine · 2026Observational
- Prophylactic NIV after extubation in non-hypercapnic high-risk patients: moving beyond convenience toward clinical benefit.Intensive care medicine · 2026Article
- Risks and outcomes of extubation failure after acute stanford Type A aortic dissection: a retrospective cohort study based on propensity score matching.Journal of cardiothoracic surgery · 2026Article
- Review
- Feasibility and safety of awake extracorporeal membrane oxygenation for operating room extubation after lung transplantation.Journal of thoracic disease · 2026Article
- Interpreting reductions in reintubation after extubation: clinical implications and future directions.Intensive care medicine · 2026Article
- Interpreting reductions in reintubation after extubation: clinical implications and future directions. Author's reply.Intensive care medicine · 2026Article
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
14 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHigh-flow nasal cannula (HFNC) oxygen therapy was noninferior to noninvasive ventilation (NIV) for preventing reintubation in a heterogeneous population at high-risk for extubation failure. However, outcomes might differ in certain subgroups of patients. Thus, we aimed to determine whether NIV with active humidification is superior to HFNC in preventing reintubation in patients with ≥ 4 risk factors (very high risk for extubation failure).
methodsRandomized controlled trial in two intensive care units in Spain (June 2020‒June 2021). Patients ready for planned extubation with ≥ 4 of the following risk factors for reintubation were included: age > 65 years, Acute Physiology and Chronic Health Evaluation II score > 12 on extubation day, body mass index > 30, inadequate secretions management, difficult or prolonged weaning, ≥ 2 comorbidities, acute heart failure indicating mechanical ventilation, moderate-to-severe chronic obstructive pulmonary disease, airway patency problems, prolonged mechanical ventilation, or hypercapnia on finishing the spontaneous breathing trial. Patients were randomized to undergo NIV with active humidification or HFNC for 48 h after extubation. The primary outcome was reintubation rate within 7 days after extubation. Secondary outcomes included postextubation respiratory failure, respiratory infection, sepsis, multiorgan failure, length of stay, mortality, adverse events, and time to reintubation.
resultsOf 182 patients (mean age, 60 [standard deviation (SD), 15] years; 117 [64%] men), 92 received NIV and 90 HFNC. Reintubation was required in 21 (23.3%) patients receiving NIV vs 35 (38.8%) of those receiving HFNC (difference -15.5%; 95% confidence interval (CI) -28.3 to -1%). Hospital length of stay was lower in those patients treated with NIV (20 [12‒36.7] days vs 26.5 [15‒45] days, difference 6.5 [95%CI 0.5-21.1]). No additional differences in the other secondary outcomes were observed.
conclusionsAmong adult critically ill patients at very high-risk for extubation failure, NIV with active humidification was superior to HFNC for preventing reintubation.
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