Please use this identifier to cite or link to this item: https://doi.org/10.47102/annals-acadmedsg.2020564
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dc.titlePredictors and outcomes of high-flow nasal cannula failure following extubation: A multicentre observational study
dc.contributor.authorKansal, Amit
dc.contributor.authorDhanvijay, Shekhar
dc.contributor.authorLi, Andrew
dc.contributor.authorPhua, J.
dc.contributor.authorCove, Matthew Edward
dc.contributor.authorOng, Wei Jun Dan
dc.contributor.authorPuah, Ser Hon
dc.contributor.authorNg, Vicky
dc.contributor.authorTAN QIAO LI
dc.contributor.authorManalansan, Julipie Sumampong
dc.contributor.authorZamora, Michael Sharey Nocon
dc.contributor.authorVidanes, Michael Camba
dc.contributor.authorSahagun, Juliet Tolentino
dc.contributor.authorTaculod, Juvel
dc.contributor.authorTAN YONG HUI ADDY
dc.contributor.authorTAY CHEE KIANG MELVIN
dc.contributor.authorCHIA YEW WOON
dc.contributor.authorSEWA DUU WEN(CAI DUWEN)
dc.contributor.authorChew, Meiying
dc.contributor.authorLew, Sennen JW
dc.contributor.authorGoh, Shirley
dc.contributor.authorTan, Jonathan Jit-Ern
dc.contributor.authorRamanathan, Kollengode
dc.contributor.authorMukhopadhyay, A.
dc.contributor.authorSee, K.C.
dc.date.accessioned2021-11-30T00:47:10Z
dc.date.available2021-11-30T00:47:10Z
dc.date.issued2021-06-01
dc.identifier.citationKansal, Amit, Dhanvijay, Shekhar, Li, Andrew, Phua, J., Cove, Matthew Edward, Ong, Wei Jun Dan, Puah, Ser Hon, Ng, Vicky, TAN QIAO LI, Manalansan, Julipie Sumampong, Zamora, Michael Sharey Nocon, Vidanes, Michael Camba, Sahagun, Juliet Tolentino, Taculod, Juvel, TAN YONG HUI ADDY, TAY CHEE KIANG MELVIN, CHIA YEW WOON, SEWA DUU WEN(CAI DUWEN), Chew, Meiying, Lew, Sennen JW, Goh, Shirley, Tan, Jonathan Jit-Ern, Ramanathan, Kollengode, Mukhopadhyay, A., See, K.C. (2021-06-01). Predictors and outcomes of high-flow nasal cannula failure following extubation: A multicentre observational study. ANNALS ACADEMY OF MEDICINE SINGAPORE 50 (6) : 467-473. ScholarBank@NUS Repository. https://doi.org/10.47102/annals-acadmedsg.2020564
dc.identifier.issn0304-4602
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/208663
dc.description.abstractINTRODUCTION: Despite adhering to criteria for extubation, up to 20% of intensive care patients require re-intubation, even with use of post-extubation high-flow nasal cannula (HFNC). This study aims to identify independent predictors and outcomes of extubation failure in patients who failed post-extubation HFNC. METHODS: We conducted a multicentre observational study involving 9 adult intensive care units (ICUs) across 5 public hospitals in Singapore. We included patients extubated to HFNC following spontaneous breathing trials. We compared patients who were successfully weaned off HFNC with those who failed HFNC (defined as re-intubation ≤7 days following extubation). Generalised additive logistic regression analysis was used to identify independent risk factors for failed HFNC. RESULTS: Among 244 patients (mean age: 63.92±15.51 years, 65.2% male, median APACHE II score 23.55±7.35), 41 (16.8%) failed HFNC; hypoxia, hypercapnia and excessive secretions were primary reasons. Stroke was an independent predictor of HFNC failure (odds ratio 2.48, 95% confidence interval 1.83-3.37). Failed HFNC, as compared to successful HFNC, was associated with increased median ICU length of stay (14 versus 7 days, P<0.001), ICU mortality (14.6% versus 2.0%, P<0.001) and hospital mortality (29.3% versus 12.3%, P=0.006). CONCLUSION: Post-extubation HFNC failure, especially in patients with stroke as a comorbidity, remains a clinical challenge and predicts poorer clinical outcomes. Our observational study highlights the need for future prospective trials to better identify patients at high risk of post-extubation HFNC failure.
dc.language.isoen
dc.publisherACAD MEDICINE SINGAPORE
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectMedicine, General & Internal
dc.subjectGeneral & Internal Medicine
dc.subjectAdult
dc.subjectairway extubation
dc.subjecthigh-flow nasal cannula
dc.subjectmechanical ventilation
dc.subjectrespiratory failure
dc.subjectPOSTEXTUBATION RESPIRATORY-FAILURE
dc.subjectNONINVASIVE VENTILATION
dc.subjectRISK
dc.subjectREINTUBATION
dc.subjectMORTALITY
dc.subjectDELIVERY
dc.typeArticle
dc.date.updated2021-11-29T08:25:34Z
dc.contributor.departmentANAESTHESIA
dc.contributor.departmentMEDICINE
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.doi10.47102/annals-acadmedsg.2020564
dc.description.sourcetitleANNALS ACADEMY OF MEDICINE SINGAPORE
dc.description.volume50
dc.description.issue6
dc.description.page467-473
dc.published.statePublished
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