• Pongdhep Theerawit, Nattawat Natpobsuk, Tananchai Petnak, and Yuda Sutherasan.
• Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
• J Crit Care. 2021 Jun 1; 63: 117-123.

PurposeCompare the efficacy(reintubation rate) between a high-flow nasal cannula(HFNC) and the WhisperFlow CPAP system in patients at risk for postextubation failure.Material And MethodsRCT was conducted in patients who had at least one high-risk criterion for postextubation failure. All patients were randomly assigned to CPAP or HFNC for 48 h.ResultsOf 140 patients, sixty-nine were assigned to the CPAP group and 71 to the HFNC group. The reintubation rate was similar between the HFNC and WhisperFlowCPAP [5 cases(7.0%) vs. 6 cases(8.7%); P = 0.76]. The postextubation respiratory failure rate was not significantly different between the HFNC and WhisperFlow CPAP groups [10 cases(14.1%)vs.7cases(10.1%); P = 0.48]. The respiratory rate was lower in the HFNC than CPAP group(P = 0.04). The pain rating scale score was lower in the HFNC group than in the WhisperFlow CPAP group at 24 h (2.8 ± 2.0 vs. 3.7 ± 1.9, P = 0.02) and 48 h (2.8 ± 1.8 vs. 3.8 ± 1.9, P = 0.002).ConclusionsWe are unable to demonstrate a reduction in postextubation respiratory failure in at risk patients with the use of HFNC compared with the WhisperFlow CPAP system probably because small sample size, but HFNC was better tolerated.Copyright © 2020 Elsevier Inc. All rights reserved.

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