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Objective <p>This study compared the effectiveness of noninvasive positive pressure ventilation (NIPPV) and high-flow nasal cannula (HFNC) in preventing reintubation among neurosurgical intensive care patients following extubation.</p> Methods <p>A retrospective cohort study was conducted on neurosurgical ICU patients who received either NIPPV or HFNC after extubation. Propensity score matching was applied to balance baseline characteristics between the two groups. The primary outcome was reintubation rate, analyzed using Kaplan–Meier survival estimates and Cox proportional hazards regression. Subgroup analyses were performed to evaluate potential effect modifiers.</p> Results <p>Among 202 matched patients, the overall reintubation event count was 48. Kaplan–Meier analysis showed no significant difference in cumulative reintubation rate between groups (log-rank <i>p</i> = 0.704). Cumulative reintubation rate at 168&#xa0;h was 24.8% for NIPPV and 22.8% for HFNC. Cox regression demonstrated a nonsignificant hazard ratio of 0.90 (95% CI, 0.51–1.58; <i>p</i> = 0.706) for HFNC compared with NIPPV. Subgroup analyses confirmed no significant effect modifications across various clinical variables. The exploratory analyses revealed that there was no significant difference in the reintubation rate between the prophylactic and the rescue NRS groups (prophylactic NRS: 25.0% vs. rescue NRS: 22.8%; <i>p</i> = 0.717).</p> Conclusions <p>In a retrospective study of neurosurgical intensive care patients, HFNC and NIPPV showed similar efficacy in preventing reintubation. Moreover, prophylactic and rescue NRS were not associated with reintubation. Prospective trials are needed to confirm treatment effects in this population.</p>

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Retrospective Propensity-Matched Comparison of Noninvasive Positive Pressure Ventilation Versus High-Flow Nasal Cannula on Reintubation Rates in Neurosurgical Intensive Care Patients

  • 期刊论文

  • 发表日期：

    2026年5月11日

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  • Jianwen Wang,
  • Yinxia Lv,
  • Yihua Zeng,
  • Mei Huang,
  • Shurong Zhang,
  • Xiaozhou Feng,
  • Zhi Li,
  • Yan Zhou,
  • Guopeng Liang,
  • Qin Wu

摘要

Objective

This study compared the effectiveness of noninvasive positive pressure ventilation (NIPPV) and high-flow nasal cannula (HFNC) in preventing reintubation among neurosurgical intensive care patients following extubation.

Methods

A retrospective cohort study was conducted on neurosurgical ICU patients who received either NIPPV or HFNC after extubation. Propensity score matching was applied to balance baseline characteristics between the two groups. The primary outcome was reintubation rate, analyzed using Kaplan–Meier survival estimates and Cox proportional hazards regression. Subgroup analyses were performed to evaluate potential effect modifiers.

Results

Among 202 matched patients, the overall reintubation event count was 48. Kaplan–Meier analysis showed no significant difference in cumulative reintubation rate between groups (log-rank p = 0.704). Cumulative reintubation rate at 168 h was 24.8% for NIPPV and 22.8% for HFNC. Cox regression demonstrated a nonsignificant hazard ratio of 0.90 (95% CI, 0.51–1.58; p = 0.706) for HFNC compared with NIPPV. Subgroup analyses confirmed no significant effect modifications across various clinical variables. The exploratory analyses revealed that there was no significant difference in the reintubation rate between the prophylactic and the rescue NRS groups (prophylactic NRS: 25.0% vs. rescue NRS: 22.8%; p = 0.717).

Conclusions

In a retrospective study of neurosurgical intensive care patients, HFNC and NIPPV showed similar efficacy in preventing reintubation. Moreover, prophylactic and rescue NRS were not associated with reintubation. Prospective trials are needed to confirm treatment effects in this population.