High-flow conditioned oxygen therapy in preventing extubation failure

Abstract

After recovery from the pathological process that has motivated the application of mechanical ventilation (MV), its removal as early as possible is always a fundamental objective. Current extubation criteria are not optimal, as 13-15% of patients need to be reintubated and this translates into mortality rates of 25-50%. Since other therapeutic alternatives to reintubation have not shown effectiveness in post-extubation respiratory failure, it is necessary to employ preventive measures. Work on preventing extubation failure has focused on specific causes of extubation failure [Ex. laryngeal edema and hypercapnia in patients with chronic obstructive pulmonary disease (COPD)] or in high-risk populations in which the benefit of the preventive role of non-invasive mechanical ventilation (NIV) has been demonstrated. Technological advances have allowed the development of high flow conditioned oxygen therapy (OAF); an oxygen support modality that offers air conditioning up to physiological situations (37ºC and 100% relative humidity), with a flow greater than 30 L / min and an inspired fraction of oxygen (FiO2) of up to 100%.