The Efficacy of High-Flow Oxygen Therapy vs. Standard Oxygen Therapy in Preventing Extubation Failure Within 72 Hours of Extubation in Critically Ill Patients

Abstract

Abstract: Background: Extubation Failure (EF) is a common complication in critically ill patients and is associated with increased morbidity and mortality. High-Flow Oxygen Therapy (HFOT) has been proposed as a strategy to reduce EF compared to Standard Oxygen (SO), yet its effectiveness remains uncertain. Aim: To determine whether HFOT reduces the incidence of EF within 72 hours of extubation compared to SO in critically ill adult patients. Methods: I conducted a systematic literature search using MEDLINE, EMBASE, CENTRAL, and CINAHL. Only randomised controlled trials (RCTs) involving adults in the Intensive Care Units (ICUs) and comparing HFOT and SO with reducing the EF or reintubation rate as a primary outcome were included. Seven RCTs met the inclusion criteria and were critically appraised using the CASP checklist. Results: Some RCTs demonstrated a significant reduction in EF with HFOT, especially in low-risk. However, other trials showed no significant difference. Moreover, methodological limitations, including small sample sizes and lack of blinding, were noted in several studies. Conclusion: HFOT may be more effective than SO in reducing EF in selected ICU populations. However, due to inconsistent findings and limited generalisability, further large-scale, high-quality RCTs are needed to establish its clinical and cost-effectiveness.