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Comparison of high flow nasal cannula and conventional oxygen therapy post-extubation in intensive care unit: A prospective crossover observational study

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Original Article

Author Details : Anil R Shetty, Gouri Pratyusha Kintamani, Govindraj M Bhat*

Volume : 12, Issue : 1, Year : 2025

Article Page : 125-131

https://doi.org/10.18231/j.ijca.2025.019

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Abstract

Background: Post-extubation respiratory support is crucial for optimal recovery and preventing reintubation in intensive care unit (ICU) patients. High Flow Nasal Oxygen (HFNO) has emerged as an effective alternative to conventional oxygen therapy (COT) for maintaining oxygenation and improving patient outcomes after extubation. This study aimed to compare the effects of HFNO and conventional oxygen therapy on dyspnea scores, arterial blood gas (ABG) parameters, physiological variables such as respiratory rate (RR), heart rate (HR), blood pressure, and patient comfort.
Materials and Methods: ICU patients who were mechanically ventilated, ready for extubation, and had successfully completed a Spontaneous Breathing Trial (SBT) were enrolled. Participants were divided into two groups: Group A received HFNO for the first 30 minutes after extubation, followed by a Venturi Mask (VM) for the next 30 minutes. Group B received a VM immediately after extubation, followed by HFNO. Dyspnea scores were assessed using a visual analogue scale, and HR, Mean Arterial Pressure (MAP), RR, Oxygen Saturation (SpO?), and ABG parameters were recorded and compared between the two groups.
Results: Baseline hemodynamic parameters, intubation time, and comorbidities were similar between the groups (p = 0.325). Both groups showed a significant improvement in dyspnea scores with HFNO (Group A: from 34.6 to 16.4, Group B: from 33 to 19.1). HR, MAP, RR, and SpO? remained stable with both HFNO and VM, while HFNO slightly improved the Partial Pressure of Oxygen (from 154 to 177.3). Patient comfort was significantly higher with HFNO compared to VM (p = 0.003).
Conclusion: HFNO is more effective in reducing dyspnea and improving patient comfort post-extubation compared to conventional oxygen therapy, without affecting vital signs such as heart rate and respiratory rate. This suggests that HFNO is a promising modality for post-extubation oxygenation in ICU patients.
 

Keywords: High flow nasal oxygen, Venturi mask, Post-extubation oxygenation, ABG analysis, Dyspnea score..

How to cite : Shetty A R, Kintamani G P, Bhat G M, Comparison of high flow nasal cannula and conventional oxygen therapy post-extubation in intensive care unit: A prospective crossover observational study. Indian J Clin Anaesth 2025;12(1):125-131

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