English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  Reintubation is associated with high mortality. Identification of methods to avoid reintubation is needed. The aim of this study was to assess whether prophylactic noninvasive ventilation (NIV) would benefit patients with various cough strengths.    Methods  We prospectively enrolled 356 patients who successfully passed a spontaneous breathing trial in a respiratory intensive care unit. Before extubation, cough peak flow was measured. After extubation, attending physicians determined whether the patients would receive prophylactic NIV or conventional oxygen treatment (control group). Patients were followed up to 90 days postextubation or death, whichever came first.    Results  The median value of cough peak flow was 70 L/minute. Among the patients with cough peak flow ≤70 L/minute, 108 received NIV and 72 received conventional oxygen treatment. In this cohort, NIV reduced reintubation (9 % vs. 35 % at postextubation 72 h,  p  < 0.01; and 24 % vs. 49 % at postextubation 7 days,  p  < 0.01) and postextubation 90-day mortality (43 % vs. 61 %,  p  = 0.02) compared with the control group. Further, use of NIV was an independent protective factor for reintubation (OR = 0.19,  p  < 0.01 at 72 h postextubation; and OR = 0.33,  p  < 0.01 at 7 days postextubation) and for death at 90 days postextubation (OR = 0.40,  p  = 0.02). Among patients with cough peak flow >70 L/minute, 71 received NIV and 105 received conventional oxygen treatment. In this cohort, NIV did not reduce reintubation (6 % vs. 6 % at 72 h postextubation,  p  > 0.99; and 9 % vs. 9 % at 7 days postextubation,  p  > 0.99) or postextubation 90-day mortality (21 % vs. 15 %,  p  = 0.32) compared with the control group. Further, use of NIV was not associated with reintubation or postextubation 90-day mortality.    Conclusion  In a planned extubated population, prophylactic NIV benefited patients with weak cough but possibly not in patients with strong cough.

Noninvasive ventilation for avoidance of reintubation in patients with various cough strength