Effect of Noninvasive Ventilation on Postextubation Brain-Injured Patients: Looking for Evidence?\ Reply to Li et al. and to Bhattacharya et al

Taran et al thank Li et al and Bhattacharya et al for their interest in their study. Regarding the comments from Li et al, they agree with their primary message that high-flow nasal cannula (HFNC) or noninvasive positive pressure ventilation (NIPPV) can be considered to attenuate reintubation risk i...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2023-12, Vol.208 (11), p.1244
Main Authors: Bhattacharya, Dipasri, Esquinas, Antonio M, Mandal, Mohanchandra
Format: Article
Language:English
Subjects:
Chronic obstructive pulmonary disease
Comorbidity
Medical treatment
Risk factors
Ventilation
Online Access:Get full text
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Summary:Taran et al thank Li et al and Bhattacharya et al for their interest in their study. Regarding the comments from Li et al, they agree with their primary message that high-flow nasal cannula (HFNC) or noninvasive positive pressure ventilation (NIPPV) can be considered to attenuate reintubation risk in carefully selected subgroups of patients with acute brain injury (ABI).We also agree that extubation to HFNC or NIPPV is a reasonable option when reintubation risk is believed to be driven by underlying comorbidities such as heart failure, severe obesity, or chronic obstructive pulmonary disease. Although we did not estimate associations within subgroups defined by these comorbidities, the mechanistic basis for treatment responsiveness is strong and unlikely to be modified by the presence of ABI. Therefore, extubation decisions in these subgroups might be guided by data extrapolated from studies in other populations without ABI.
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.202308-1442LE