Nasal pillow noninvasive ventilation versus high-flow nasal therapy after extubation in surgical intensive care patients: A propensity-matched cohort study

J Int Med Res. 2022 Jul;50(7):3000605221112777. doi: 10.1177/03000605221112777.

Abstract

Objective: To evaluate the tolerability and efficacy of nasal pillow-noninvasive ventilation (NP-NIV) compared with high-flow nasal therapy (HFNT) in postsurgical patients.

Methods: This propensity score-matched retrospective study enrolled postoperative patients that received NP-NIV (NP-NIV group) or HFNT (HFNT group) in the intensive care unit. Data were collected from their medical records and the tolerability and respiratory status before and after extubation were compared between the two groups.

Results: The study enrolled 83 patients in the NP-NIV group and 27 patients in the HFNT group. After propensity score matching, there were 19 patients in each group. After matching, there were no significant differences in the baseline demographic and clinical characteristics before extubation. The tolerability was similar in both groups. When the NP-NIV group was compared with the HFNT group, the respiratory rate was significantly lower (median 16 [interquartile range, 14-17] versus median 19 [interquartile range, 18-26], respectively) and the partial pressure of arterial oxygen/fraction of inspired oxygen ratio was significantly higher (median 205 [174-256] versus median 155 [130-192], respectively) at 1 h after extubation.

Conclusion: NP-NIV was equally well tolerated and provided better respiratory support than HFNT in postsurgical patients.

Keywords: Noninvasive ventilation; acute respiratory failure; high-flow nasal therapy; nasal pillow mask; postextubation; postoperative.

MeSH terms

  • Airway Extubation
  • Cohort Studies
  • Critical Care
  • Humans
  • Intensive Care Units
  • Noninvasive Ventilation*
  • Oxygen
  • Oxygen Inhalation Therapy
  • Respiratory Insufficiency* / therapy
  • Retrospective Studies

Substances

  • Oxygen