Effect of High flow nasal cannula versus conventional Venturi mask oxygenation after planned extubation in intensive care unit patients.

Majority of  ICU patients often require endotracheal intubation and mechanical ventilation .As a standard protocol, intubated ICU patients after the resolution of underlying disease are gradually weaned from mechanical ventilation and there after extubated. Oxygenation and ventilation impairment may be seen in some patients after extubation. Post extubation respiratory management by supplemental oxygen therapy aims at decreasing early post extubation respiratory failure. Several devices are available for delivering oxygen to the ICU patients, which can be either a high flow system or low flow system . Venturi mask being routinely used since years for oxygen supplementation after extubation. It is a high flow oxygen delivery device which has the advantage of delivering precise Fio2 upto a maximum of 0.60.Inspite of being a high flow device it has disadvantage of air entrainement when the respiratory demand of patient increases leading to dilution of oxygen and also delivers non humidified oxygen which leads to airway mucosa dryness.

Recently a new high flow device (AIRVO2) is being increasingly used. In this high flow device patients inhale a higher percentage of oxygen which saturates the nasopharynx with oxygen and increases the oxygen reserve in lungs. It can deliver oxygen upto 70L/min and FiO2 reaching upto 0.99-1.00.Gaseous exchange is facilitated by flow dependant dead space flushing .

We hypothesize that High Flow Nasal Cannula (AIRVO2) may provide better oxygenation and comfort to the patient with better recruitement of alveoli after planned extubation than conventional oxygen therapy.