{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T10:36:50Z","timestamp":1788691010322,"version":"build-2803163510"},"reference-count":40,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2017,8,14]],"date-time":"2017-08-14T00:00:00Z","timestamp":1502668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Obese patients are considered at risk of respiratory failure after cardiothoracic surgery. High-flow nasal cannula has demonstrated its non-inferiority after cardiothoracic surgery compared to noninvasive ventilation (NIV), which is the recommended treatment in obese patients. We hypothesized that NIV was superior to high-flow nasal cannula for preventing or resolving acute respiratory failure after cardiothoracic surgery in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      We performed a post hoc analysis of a randomized, controlled trial. Obese subjects were randomly assigned to receive NIV for at least 4 h\/d (inspiratory pressure, 8 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O; expiratory pressure, 4 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O; F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      , 0.5) or high-flow nasal cannula delivered continuously (flow, 50 L\/min, F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      0.5).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Treatment failure (defined as re-intubation, switch to the other treatment, or premature discontinuation) occurred in 21 of 136 (15.4%, 95% CI 9.8\u201322.6%) subjects with NIV compared to 18 of 135 (13.3%, 95% CI 8.1\u201320.3%) subjects with high-flow nasal cannula (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .62). No significant differences were found for dyspnea and comfort scores. Skin breakdown was significantly more common with NIV after 24 h (9.2%, 95% CI 5.0\u201316.0 vs 1.6%, 95% CI 1.0\u20136.0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01). No significant differences were found for ICU mortality (5.9% for subjects with NIV vs 2.2% for subjects with high-flow nasal cannula,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .22) or for any of the other secondary outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      Among obese cardiothoracic surgery subjects with or without respiratory failure, the use of continuous high-flow nasal cannula compared to intermittent NIV (8\/4 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O) did not result in a worse rate of treatment failure. Because high-flow nasal cannula presents some advantages, it may be used instead of NIV in obese patients after cardiothoracic surgery.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.05473","type":"journal-article","created":{"date-parts":[[2017,8,14]],"date-time":"2017-08-14T20:50:16Z","timestamp":1502743816000},"page":"1193-1202","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":76,"title":["High-Flow Nasal Cannula Therapy Versus Intermittent Noninvasive Ventilation in Obese Subjects After Cardiothoracic Surgery"],"prefix":"10.1177","volume":"62","author":[{"given":"Fran\u00e7ois","family":"St\u00e9phan","sequence":"first","affiliation":[{"name":"Service de R\u00e9animation adulte, H\u00f4pital Marie Lannelongue, Le Plessis Robinson, 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