Tuberc Respir Dis > Epub ahead of print
DOI: https://doi.org/10.4046/trd.2022.0040    [Epub ahead of print]
Published online July 13, 2022.
Cardiac Dysfunction Is Not Associated with Increased Reintubation Rate in Patients Treated with Post-extubation High-Flow Nasal Cannula
Jae Kyeom Sim, M.D.  , Juwhan Choi, M.D., Jee Youn Oh, M.D., Kyung Hoon Min, M.D., Gyu Young Hur, M.D., Sung Yong Lee, M.D., Jae Jeong Shim, M.D., Young Seok Lee, M.D. 
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
Correspondence:  Young Seok Lee, Tel: 82-2-2626-3256, Fax: 82-2-2626-1166, 
Email: avonlea76@korea.ac.kr
Received: 30 March 2022   • Revised: 13 June 2022   • Accepted: 6 July 2022
Abstract
Background
Cardiac dysfunction patients have long been considered at high risk of reintubation. However, it is based on past studies in which only conventional oxygen therapy was applied after extubation. We investigated association between cardiac dysfunction and reintubation rate in situation where high-flow nasal cannula (HFNC) was widely used during post-extubation period.
Methods
We conducted a retrospective observational cohort study of patients treated with HFNC after planned extubation in medical intensive care unit of single tertiary center. Patients were divided into normal function group (ejection fraction [EF] ≥45%) and cardiac dysfunction group (EF <45%). The primary outcome was reintubation rate within 72 hours following extubation.
Results
Of 270 patients, 35 (13%) had cardiac dysfunction. Baseline characteristics were similar in both groups. There were no differences in the changes in vital signs between the two groups during the first 12 hours after extubation except diastolic blood pressure. The reintubation rates were 20% and 17% for cardiac dysfunction group and normal function group, respectively (p=0.637). In a multivariate Cox regression analysis, cardiac dysfunction was not associated with an increased risk of reintubation within 72 hours following extubation (hazard ratio, 1.56; p=0.292).
Conclusion
Cardiac dysfunction was not associated with increased reintubation rate within 72 hours when HFNC is immediately applied after planned extubation.
Key Words: High-Flow Nasal Cannula, Extubation, Reintubation, Cardiac Dysfunction
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ORCID iDs

Jae Kyeom Sim
https://orcid.org/000-0003-0873-2807

Young Seok Lee
https://orcid.org/0000-0002-0144-2033

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