Temporal trends in post-extubation respiratory management and reintubation risk factors in Japan: A retrospective multicenter cohort study

Objective: Non-invasive ventilation (NIV) and high-flow nasal cannula (HFNC) have been used to prevent reintubation. We aimed to describe the utilisation patterns and analyze temporal trends of NIV and HFNC after extubation. Design: Retrospective multicenter cohort study using the Japanese Intensive care PAtient Database (JIPAD) from 2018 to 2022. Setting: Facilities that consecutively registered cases in JIPAD during the study period. Participants: We included adult patients (>18 years) who were receiving mechanical ventilation at the time of intensive care unit (ICU) admission, with a duration of mechanical ventilation of at least 24 h. Interventions: None. Main outcome measures: Temporal trends in the utilisation of NIV and HFNC after extubation over the 5-year study period. Results: We included 12,687 eligible patients from 40 ICUs. Based on the Cochran-Armitage test, the proportion of patients receiving NIV decreased from the years 2018 to 2022 (6.7-3.9 %, P for trend