Gonzalo Hernández Martínez, Patricia Rodriguez, Jesus Soto, Oriol Caritg, Andrea Castellví-Font, Borja Mariblanca, Antonio Maria García, Laura Colinas, Jose Manuel Añon, Francisco Jose Parrilla-Gomez, Jose Alberto Silva-Obregón, Joan Ramon Masclans, Alicia Propin, Alicia Cuadra, Mario Guillermo Dalorzo, Gemma Rialp, Fernando Suarez-Sipmann, Oriol Roca
PURPOSE: This study aimed to determine the best strategy to achieve fast and safe extubation. METHODS: This multicenter trial randomized patients with primary respiratory failure and low-to-intermediate risk for extubation failure with planned high-flow nasal cannula (HFNC) preventive therapy. It included four groups: (1) conservative screening with ratio of partial pressure of arterial oxygen (PaO2 ) to fraction of inspired oxygen (FiO2 ) ≥ 150 and positive end-expiratory pressure (PEEP) ≤ 8 cmH2 O plus conservative spontaneous breathing trial (SBT) with pressure support 5 cmH2 O + PEEP 0 cmH2 O); (2) screening with ratio of partial pressure of arterial oxygen (PaO2 ) to fraction of inspired oxygen (FiO2 ) ≥ 150 and PEEP ≤ 8 plus aggressive SBT with pressure support 8 + PEEP 5; (3) aggressive screening with PaO2 /FiO2 > 180 and PEEP 10 maintained until the SBT with pressure support 8 + PEEP 5; (4) screening with PaO2 /FiO2 > 180 and PEEP 10 maintained until the SBT with pressure support 5 + PEEP 0...
February 14, 2024: Intensive Care Medicine