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Efficacy and Safety of Non-Invasive Ventilation for Post Extubation Respiratory Distress in Hypoxic and Hypercapnic Respiratory Failure

Alaa Mohammed Atia, Khaled Abdel-Baqy Abdel-Rahman and Khaled Ahmed Hussein

Background: Respiratory distress after extubation with the need for reintubation is a common event. The act of reintubation is associated with numerous life-threatening complication and high mortality rate. The role of noninvasive ventilation (NIV) in patients who developed respiratory distress is not clear.

Aim of the study: To assess the effectiveness of non-invasive pressure support ventilation (NIPPV) in avoiding reintubation in patients who develop respiratory distress after extubation in hypoxic and hypercapnic patients.

Patients and methods: In this prospective observational study, one hundred and three patients with post extubation respiratory distress met our inclusion and exclusion criteria and were enrolled. NIPPV were applied to all patients and they were monitored for signs of failure of this technique and the need for reintubation. This cohort is further divided according to the initial cause of respiratory failure into hypoxic and hypercapnic groups. The primary outcome measure was the technique success rate to avoid reintubation; secondary outcome measures were ICU mortality, length of ICU stay.

Results: No statistically significant differences were observed in success rate, mortality and length of ICU stay between both groups.

Conclusion: The type of respiratory failure as a primary etiology for mechanical ventilation does not affect the success rate of the use of NIPPV in patients who developed post extubation respiratory distress.