Evidence-based practice of oxygenation strategies therapy for intensive care unit adult patients with tracheal intubation after extubation_West China Medical Journal

Authors：

HU Caixia ¹ , CHEN Rui ¹ , LI Yuefeng ¹ , TAN Miaoqing ¹ , LIU Shuying ¹ , JIANG Minqing ¹ ,  WEI Lin ²

1. Department of Neurology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, P. R. China;
2. State Key of Traditional Chinese Medicine Syndrome, the Second Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, P. R. China;

Corresponding author：

WEI Lin, Email: weilin22@126.com

Keywords：

Intensive care unit; tracheal intubation after extubation; oxygenation strategy; evidence-based practice

DOI：

10.7507/1002-0179.202311066

Video：

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Objective To evaluate and summarize the relevant evidence of oxygenation strategies with tracheal intubation after extubation for adult in intensive care unit (ICU), and to provide evidence-based practice for the development of scientific and effective strategies tracheal intubation after extubation for ICU adult patients. Methods Evidence-based databases, related guideline websites, association websites and original databases were searched by computer for literature about oxygenation strategies with tracheal intubation after extubation for ICU adults patients was extracted. The retrieval time was from the establishment of the databases to May 2023. Two researchers trained in evidence-based practice evaluated the quality of the included literature and extracted evidence from the literature that met the quality evaluation criteria. Results A total of 18 articles were included, including 7 guidelines, 4 clinical decisions, 2 expert consensus, 4 systematic reviews and 1 randomized controlled trial. A total of 22 pieces of best evidence were formed, including 7 aspects of basic principles, evaluation, selection, parameter setting, withdrawal, effect evaluation and precautions. Conclusion The medical staff should select the best evidence based on the actual clinical situation and the patient’s own needs, and adjust the oxygenation strategies to reduce the rate of tracheal intubation and improve the prognosis of patients.

Citation： HU Caixia, CHEN Rui, LI Yuefeng, TAN Miaoqing, LIU Shuying, JIANG Minqing, WEI Lin. Evidence-based practice of oxygenation strategies therapy for intensive care unit adult patients with tracheal intubation after extubation. West China Medical Journal, 2024, 39(8): 1265-1272. doi: 10.7507/1002-0179.202311066 Copy

1.	Tanaka A, Uchiyama A, Horiguchi Y, et al. Predictors of post-extubation stridor in patients on mechanical ventilation: a prospective observational study. Sci Rep, 2021, 11(1): 19993.
2.	周红芳, 兰旭红, 贾东珲, 等. ICU 成人气管插管患者围拔管期管理的最佳证据总结. 中华急危重症护理杂志, 2024, 5(1): 33-39.
3.	Zhu Y, Yin H, Zhang R, et al. High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients after planned extubation: a systematic review and meta-analysis. Crit Care, 2019, 23(1): 180.
4.	Chen L, Xie W, Zheng D, et al. Early extubation after thymectomy is good for the patients with myasthenia gravis. Neurol Sci, 2019, 40(10): 2125-2132.
5.	刘飞跃, 葛伟婷, 张帅, 等. 气管插管病人再插管危险因素及预防措施研究进展. 护理研究, 2022, 36(19): 3455-3458.
6.	Maggiore SM, Battilana M, Serano L, et al. Ventilatory support after extubation in critically ill patients. Lancet Respir Med, 2018, 6(12): 948-962.
7.	Hernández G, Vaquero C, Colinas L, et al. Effect of postextubation high-flow nasal cannula vs noninvasive ventilation on reintubation and postextubation respiratory failure in high- risk patients: a randomized clinical trial. JAMA, 2016, 316(15): 1565-1574.
8.	潘宸, 朱涵菁, 杨鹏飞, 等. ICU 气管插管拔管后病人应用经鼻高流量湿化氧疗的最佳证据总结. 护理研究, 2022, 36(3): 421-427.
9.	喻正浩, 张瑞, 黄卉, 等. 经鼻高流量湿化氧疗应用于慢性阻塞性肺疾病合并 2 型呼吸衰竭患者气管插管拔管后的疗效和安全性: 随机对照研究. 第二军医大学学报, 2019, 40(9): 989-994.
10.	Maggiore SM, Idone FA, Vaschetto R, et al. Nasal high-flow versus venturi mask oxygen therapy after extubation. Effects on oxygenation, comfort, and clinical outcome. Am J Respir Crit Care Med, 2014, 190(3): 282-288.
11.	Rochwerg B, Brochard L, Elliott MW, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J, 2017, 50(2): 1602426.
12.	Schmidt GA, Girard TD, Kress JP, et al. Official executive summary of an American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: liberation from mechanical ventilation in critically ill adults. Am J Respir Crit Care Med, 2017, 195(1): 115-119.
13.	朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成. 护士进修杂志, 2017, 32(21): 1991-1994.
14.	Dicenso A, Bayley L, Haynes RB. Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evid Based Nurs, 2009, 12(4): 99-101.
15.	韦当, 王聪尧, 肖晓娟, 等. 指南研究与评价(AGREEⅡ)工具实例解读. 中国循证儿科杂志, 2013, 8(4): 316-319.
16.	Foster MJ, Shurtz S. Making the critical appraisal for summaries of evidence (CASE) for evidence-based medicine (EBM): critical appraisal of summaries of evidence. J Med Libr Assoc, 2013, 101(3): 192-198.
17.	胡雁, 郝玉芳. 循证护理学. 2 版. 北京: 人民卫生出版社, 2018.
18.	顾莺, 张慧文, 周英凤, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具——系统评价的方法学质量评价. 护士进修杂志, 2018, 33(8): 701-703.
19.	Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 2007, 7: 10.
20.	周英凤, 顾莺, 胡雁, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具——干预性研究的质量评价(一). 护士进修杂志, 2018, 33(1): 24-26.
21.	王春青, 胡雁. JBI 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 2015, 30(11): 964-967.
22.	Hyzy RC. Extubation management in the adult intensive care unit. Up To Date, 2023.
23.	Hyzy RC, McSparron JI. Noninvasive ventilation in adults with acute respiratory failure: Benefits and contraindications. Up To Date, 2023.
24.	Hyzy RC. Heated and humidified high-flow nasal oxygen in adults: practical considerations and potential applications. Up To Date, 2023.
25.	Oczkowski S, Ergan B, Bos L, et al. ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure. Eur Respir J, 2022, 59(4): 2101574.
26.	Fernando SM, Tran A, Sadeghirad B, et al. Noninvasive respiratory support following extubation in critically ill adults: a systematic review and network meta-analysis. Intensive Care Med, 2022, 48(2): 137-147.
27.	中国医师协会急诊医师分会, 中华医学会急诊医学分会, 中国急诊专科医联体, 等. 急诊成人经鼻高流量氧疗临床应用专家共识. 中国急救医学, 2021, 41(9): 739-749.
28.	Yasuda H, Okano H, Mayumi T, et al. Post-extubation oxygenation strategies in acute respiratory failure: a systematic review and network meta-analysis. Crit Care, 2021, 25(1): 135.
29.	Qaseem A, Etxeandia-Ikobaltzeta I, Fitterman N, et al. Appropriate use of high-flow nasal oxygen in hospitalized patients for initial or postextubation management of acute respiratory failure: a clinical guideline from the American College of Physicians. Ann Intern Med, 2021, 174(7): 977-984.
30.	Rochwerg B, Einav S, Chaudhuri D, et al. The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline. Intensive Care Med, 2020, 46(12): 2226-2237.
31.	Thille AW, Muller G, Gacouin A, et al. Effect of postextubation high-flow nasal oxygen with noninvasive ventilation vs high-flow nasal oxygen alone on reintubation among patients at high risk of extubation failure: a randomized clinical trial. JAMA, 2019, 322(15): 1465-1475.
32.	中华医学会呼吸病学分会呼吸危重症医学学组, 中国医师协会呼吸医师分会危重症医学工作委员会. 成人经鼻高流量湿化氧疗临床规范应用专家共识. 中华结核和呼吸杂志, 2019, 42(2): 83-91.
33.	Huang HW, Sun XM, Shi ZH, et al. Effect of high-flow nasal cannula oxygen therapy versus conventional oxygen therapy and noninvasive ventilation on reintubation rate in adult patients after extubation: a systematic review and meta-analysis of randomized controlled trials. J Intensive Care Med, 2018, 33(11): 609-623.
34.	Akashiba T, Ishikawa Y, Ishihara H, et al. The Japanese respiratory society noninvasive positive pressure ventilation (NPPV) guidelines (second revised edition). Respir Investig, 2017, 55(1): 83-92.
35.	Difficult Airway Society Extubation Guidelines Group; Popat M, Mitchell V, et al. Difficult airway society guidelines for the management of tracheal extubation. Anaesthesia, 2012, 67(3): 318-340.
36.	Hyzy RC, McSparron JI. Noninvasive ventilation in adults with acute respiratory failure: practical aspects of initiation. Up To Date, 2024.
37.	Esteban A, Frutos-Vivar F, Muriel A, et al. Evolution of mortality over time in patients receiving mechanical ventilation. Am J Respir Crit Care Med, 2013, 188(2): 220-230.
38.	李玉冰, 李凡, 马俊, 等. ICU 患者机械通气撤机后序贯经鼻高流量湿化氧疗安全性和有效性的 Meta 分析. 中华现代护理杂志, 2021, 27(24): 3279-3287.
39.	刘秀梅, 龚平, 康健, 等. 基于指南和 RCT 研究的 ICU 成人机械通气患者气管插管拔管管理的最佳证据总结. 中华危重病急救医学, 2021, 33(8): 927-932.
40.	Maggiore SM, Jaber S, Grieco DL, et al. High-flow versus venturimask oxygen therapy to prevent reintubation in hypoxemic patients after extubation: a multicenter randomized clinical trial. Am J Respir Crit Care Med, 2022, 206(12): 1452-1462.

1. Tanaka A, Uchiyama A, Horiguchi Y, et al. Predictors of post-extubation stridor in patients on mechanical ventilation: a prospective observational study. Sci Rep, 2021, 11(1): 19993.
2. 周红芳, 兰旭红, 贾东珲, 等. ICU 成人气管插管患者围拔管期管理的最佳证据总结. 中华急危重症护理杂志, 2024, 5(1): 33-39.
3. Zhu Y, Yin H, Zhang R, et al. High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients after planned extubation: a systematic review and meta-analysis. Crit Care, 2019, 23(1): 180.
4. Chen L, Xie W, Zheng D, et al. Early extubation after thymectomy is good for the patients with myasthenia gravis. Neurol Sci, 2019, 40(10): 2125-2132.
5. 刘飞跃, 葛伟婷, 张帅, 等. 气管插管病人再插管危险因素及预防措施研究进展. 护理研究, 2022, 36(19): 3455-3458.
6. Maggiore SM, Battilana M, Serano L, et al. Ventilatory support after extubation in critically ill patients. Lancet Respir Med, 2018, 6(12): 948-962.
7. Hernández G, Vaquero C, Colinas L, et al. Effect of postextubation high-flow nasal cannula vs noninvasive ventilation on reintubation and postextubation respiratory failure in high- risk patients: a randomized clinical trial. JAMA, 2016, 316(15): 1565-1574.
8. 潘宸, 朱涵菁, 杨鹏飞, 等. ICU 气管插管拔管后病人应用经鼻高流量湿化氧疗的最佳证据总结. 护理研究, 2022, 36(3): 421-427.
9. 喻正浩, 张瑞, 黄卉, 等. 经鼻高流量湿化氧疗应用于慢性阻塞性肺疾病合并 2 型呼吸衰竭患者气管插管拔管后的疗效和安全性: 随机对照研究. 第二军医大学学报, 2019, 40(9): 989-994.
10. Maggiore SM, Idone FA, Vaschetto R, et al. Nasal high-flow versus venturi mask oxygen therapy after extubation. Effects on oxygenation, comfort, and clinical outcome. Am J Respir Crit Care Med, 2014, 190(3): 282-288.
11. Rochwerg B, Brochard L, Elliott MW, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J, 2017, 50(2): 1602426.
12. Schmidt GA, Girard TD, Kress JP, et al. Official executive summary of an American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: liberation from mechanical ventilation in critically ill adults. Am J Respir Crit Care Med, 2017, 195(1): 115-119.
13. 朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成. 护士进修杂志, 2017, 32(21): 1991-1994.
14. Dicenso A, Bayley L, Haynes RB. Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evid Based Nurs, 2009, 12(4): 99-101.
15. 韦当, 王聪尧, 肖晓娟, 等. 指南研究与评价(AGREEⅡ)工具实例解读. 中国循证儿科杂志, 2013, 8(4): 316-319.
16. Foster MJ, Shurtz S. Making the critical appraisal for summaries of evidence (CASE) for evidence-based medicine (EBM): critical appraisal of summaries of evidence. J Med Libr Assoc, 2013, 101(3): 192-198.
17. 胡雁, 郝玉芳. 循证护理学. 2 版. 北京: 人民卫生出版社, 2018.
18. 顾莺, 张慧文, 周英凤, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具——系统评价的方法学质量评价. 护士进修杂志, 2018, 33(8): 701-703.
19. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 2007, 7: 10.
20. 周英凤, 顾莺, 胡雁, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具——干预性研究的质量评价(一). 护士进修杂志, 2018, 33(1): 24-26.
21. 王春青, 胡雁. JBI 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 2015, 30(11): 964-967.
22. Hyzy RC. Extubation management in the adult intensive care unit. Up To Date, 2023.
23. Hyzy RC, McSparron JI. Noninvasive ventilation in adults with acute respiratory failure: Benefits and contraindications. Up To Date, 2023.
24. Hyzy RC. Heated and humidified high-flow nasal oxygen in adults: practical considerations and potential applications. Up To Date, 2023.
25. Oczkowski S, Ergan B, Bos L, et al. ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure. Eur Respir J, 2022, 59(4): 2101574.
26. Fernando SM, Tran A, Sadeghirad B, et al. Noninvasive respiratory support following extubation in critically ill adults: a systematic review and network meta-analysis. Intensive Care Med, 2022, 48(2): 137-147.
27. 中国医师协会急诊医师分会, 中华医学会急诊医学分会, 中国急诊专科医联体, 等. 急诊成人经鼻高流量氧疗临床应用专家共识. 中国急救医学, 2021, 41(9): 739-749.
28. Yasuda H, Okano H, Mayumi T, et al. Post-extubation oxygenation strategies in acute respiratory failure: a systematic review and network meta-analysis. Crit Care, 2021, 25(1): 135.
29. Qaseem A, Etxeandia-Ikobaltzeta I, Fitterman N, et al. Appropriate use of high-flow nasal oxygen in hospitalized patients for initial or postextubation management of acute respiratory failure: a clinical guideline from the American College of Physicians. Ann Intern Med, 2021, 174(7): 977-984.
30. Rochwerg B, Einav S, Chaudhuri D, et al. The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline. Intensive Care Med, 2020, 46(12): 2226-2237.
31. Thille AW, Muller G, Gacouin A, et al. Effect of postextubation high-flow nasal oxygen with noninvasive ventilation vs high-flow nasal oxygen alone on reintubation among patients at high risk of extubation failure: a randomized clinical trial. JAMA, 2019, 322(15): 1465-1475.
32. 中华医学会呼吸病学分会呼吸危重症医学学组, 中国医师协会呼吸医师分会危重症医学工作委员会. 成人经鼻高流量湿化氧疗临床规范应用专家共识. 中华结核和呼吸杂志, 2019, 42(2): 83-91.
33. Huang HW, Sun XM, Shi ZH, et al. Effect of high-flow nasal cannula oxygen therapy versus conventional oxygen therapy and noninvasive ventilation on reintubation rate in adult patients after extubation: a systematic review and meta-analysis of randomized controlled trials. J Intensive Care Med, 2018, 33(11): 609-623.
34. Akashiba T, Ishikawa Y, Ishihara H, et al. The Japanese respiratory society noninvasive positive pressure ventilation (NPPV) guidelines (second revised edition). Respir Investig, 2017, 55(1): 83-92.
35. Difficult Airway Society Extubation Guidelines Group; Popat M, Mitchell V, et al. Difficult airway society guidelines for the management of tracheal extubation. Anaesthesia, 2012, 67(3): 318-340.
36. Hyzy RC, McSparron JI. Noninvasive ventilation in adults with acute respiratory failure: practical aspects of initiation. Up To Date, 2024.
37. Esteban A, Frutos-Vivar F, Muriel A, et al. Evolution of mortality over time in patients receiving mechanical ventilation. Am J Respir Crit Care Med, 2013, 188(2): 220-230.
38. 李玉冰, 李凡, 马俊, 等. ICU 患者机械通气撤机后序贯经鼻高流量湿化氧疗安全性和有效性的 Meta 分析. 中华现代护理杂志, 2021, 27(24): 3279-3287.
39. 刘秀梅, 龚平, 康健, 等. 基于指南和 RCT 研究的 ICU 成人机械通气患者气管插管拔管管理的最佳证据总结. 中华危重病急救医学, 2021, 33(8): 927-932.
40. Maggiore SM, Jaber S, Grieco DL, et al. High-flow versus venturimask oxygen therapy to prevent reintubation in hypoxemic patients after extubation: a multicenter randomized clinical trial. Am J Respir Crit Care Med, 2022, 206(12): 1452-1462.

West China Medical Journal

Evidence-based practice of oxygenation strategies therapy for intensive care unit adult patients with tracheal intubation after extubation

Abstract Full text Figures/Tables Video References Cited by

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