Pongdhep TheerawitNattawat NatpobsukTananchai PetnakYuda SutherasanFaculty of Medicine Ramathibodi Hospital, Mahidol UniversityMaharaj Nakhon Ratchasima Hospital2022-08-042022-08-042021-06-01Journal of Critical Care. Vol.63, (2021), 117-12315578615088394412-s2.0-85092172239https://repository.li.mahidol.ac.th/handle/20.500.14594/78194Purpose: Compare the efficacy(reintubation rate) between a high-flow nasal cannula(HFNC) and the WhisperFlow CPAP system in patients at risk for postextubation failure. Material and methods: RCT was conducted in patients who had at least one high-risk criterion for postextubation failure. All patients were randomly assigned to CPAP or HFNC for 48 h. Results: Of 140 patients, sixty-nine were assigned to the CPAP group and 71 to the HFNC group. The reintubation rate was similar between the HFNC and WhisperFlowCPAP [5 cases(7.0%) vs. 6 cases(8.7%); P = 0.76]. The postextubation respiratory failure rate was not significantly different between the HFNC and WhisperFlow CPAP groups [10 cases(14.1%)vs.7cases(10.1%); P = 0.48]. The respiratory rate was lower in the HFNC than CPAP group(P = 0.04). The pain rating scale score was lower in the HFNC group than in the WhisperFlow CPAP group at 24 h (2.8 ± 2.0 vs. 3.7 ± 1.9, P = 0.02) and 48 h (2.8 ± 1.8 vs. 3.8 ± 1.9, P = 0.002). Conclusions: We are unable to demonstrate a reduction in postextubation respiratory failure in at risk patients with the use of HFNC compared with the WhisperFlow CPAP system probably because small sample size, but HFNC was better tolerated.Mahidol UniversityMedicineArticleSCOPUS10.1016/j.jcrc.2020.09.031