Objective: To compare the extubation failure in high-flow nasal cannula [HFNC] group versus conventional oxygen therapy [COT] group in pediatric intensive care unit [PICU] patients after extubation.

Materials and Methods: The present research conducted a randomized, controlled trial in children aged 29 days to 15 years admitted to PICU, Maharat Nakhon Ratchasima Hospital, between August 1, 2016 and May 31, 2017. The patients were clinically ready for extubation after received mechanical ventilation for at least 24 hours, and were randomly allocated to HFNC or COT groups.

Results: One hundred fifty-two patients were enrolled (76 patients in each group). Extubation failure in HFNC and COT group were 11.8% and 14.5% (p = 0.81), respectively. In COT group, higher incidence of extubation failure was observed in patients aged less than one year (6.6% versus 2.6%) and mechanically ventilated time greater than seven days (2.6% versus 0). There was more atelectasis after extubation in COT group than HFNC group (15.8% versus 6.6%, p = 0.12).

Conclusion: The present study showed no statistical differences in extubation failure and adverse effects between the two groups, but there was decreasing tendency of failure and atelectasis in the HFNC group.