![]() ![]() Although NPPV/HFNC use did not significantly lower the mortality risk (relative risk 0.75 and 0.92 low and moderate certainty, respectively), HFNC use significantly lowered the reintubation risk (0.54 high certainty) compared to COT use. The main cause of acute hypoxic respiratory failure was pneumonia. ResultsĪfter evaluating 4631 records, 15 studies and 2600 patients were included. Short-term mortality and reintubation and post-extubation respiratory failure rates were compared. The GRADE Working Group Approach was performed using a frequentist-based approach with multivariate random-effect meta-analysis. COT, NPPV, and HFNC use were assessed in patients who were aged ≥ 16 years, underwent invasive mechanical ventilation for > 12 h for acute respiratory failure, and were scheduled for extubation after spontaneous breathing trials. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Ichushi databases were searched. We conducted a network meta-analysis (NMA) to compare the effectiveness of three post-extubation respiratory support devices (HFNC, NPPV, and COT) in reducing the mortality and reintubation risk. High-flow nasal cannula oxygenation (HFNC) and noninvasive positive-pressure ventilation (NPPV) possibly decrease tracheal reintubation rates better than conventional oxygen therapy (COT) however, few large-scale studies have compared HFNC and NPPV. ![]()
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