Main randomised controlled trials having assessed the use of prophylactic NIV to prevent postextubation respiratory failure in ICU
| Randomised controlled trials No of centres/inclusion criteria | Main results: NIV versus standard oxygen (O2) |
| Nava et al
3 3 centres: NIV (n=48) vs O2 (n=49) Patients considered at high risk for reintubation | Reintubation: n=4 (8%) vs n=12 (24%), p=0.027* In-ICU mortality: n=3 (6%) vs n=9 (18%), p=0.064 |
| Ferrer et al
5 2 centres: NIV (n=79) vs O2 (n=83) Age>65, APACHE II>12 or intubation for cardiac heart failure | Respiratory failure after extubation: n=13 (16%) vs n=27 (33%), p=0.029* Reintubation: n=9 (11%) vs n=18 (22%), p=0.12 Nosocomial Infections: 18 (23%) vs 27 (33%), p=NS In-ICU mortality: NIV n=2 (3%) vs. n=12 (14%), p=0.015 |
| Ferrer et al
6 3 centres: NIV (n=54) vs O2 (n=52) PCO2 >45 mm Hg at the end of the spontaneous breathing trial | Respiratory failure after extubation: n=8 (15%) vs n=25 (48%), p<0.0001* Reintubation: n=6 (11%) vs n=10 (19%), p=0.37 Pneumonias: 3 (6%) vs 9 (17%), p=0.12 In-ICU mortality: n=3 (6%) vs n=4 (8%), p=0.71 Mortality at day 90: n=6 (11%) vs n=16 (31%), p=0.024 |
| Khilnani et al
26 1 single centre: NIV (n=20) vs O2 (n=20) Patients with COPD | Reintubation: n=5 (25%) vs n=3 (15%), p=0.44* Length of ICU stay: 18.3±7.9 j vs 16.1±6.3, p=0.34 |
| Su et al
27 3 centres: NIV (n=202) vs O2 (n=204) Intubation≥48 hours | Extubation failure: n=30 (15%) vs n=27 (13%), p=0.62* Reintubation: n=21 (10%) vs n=16 (8%), p=0.37 In-ICU mortality: n=3 (1.5%) vs n=2 (1%), p=0.64 |
| Ornico et al
4 1 single centre: NIV (n=20) vs O2 (n=18) Intubation ≥3 days for respiratory failure | Reintubation: n=1 (5%) vs n=7 (39%), p=0.016* In-hospital mortality: 0% vs n=4 (22%), p=0.041 |
| Vargas et al
28 6 centres: NIV (n=71) vs O2 (n=72) Patients with chronic lung disorders | Respiratory failure after extubation: n=6 (8%) vs n=20 (28%), p=0.002* Reintubation: n=6 (8%) vs n=13 (18%), p=0.09 In-ICU mortality: n=2 (3%) vs n=6 (8%), p=0.28 Mortality at day 90: n=7 (10%) vs n=11 (15%), p=0.33 |
*Main end point.
APACHE, Acute Physiology and Chronic Health Evaluation; COPD, chronic obstructive pulmonary disease; ICU, intensive care unit; NIV, non-invasive ventilation; PCO2, partial pressure of carbon dioxide.