Thille AW, Muller G, Gacouin A, et al. - In this multicenter randomized clinical trial done from April 2017 to January 2018 among 641 individuals at great risk of extubation failure (ie, older than 65 years or with an underlying cardiac or respiratory disease) at 30 ICUs in France, researchers ascertained whether high-flow nasal oxygen with prophylactic noninvasive ventilation (NIV) applied shortly following the extubation could diminish the rate of reintubation, in comparison with high-flow nasal oxygen alone in such patients. Amongst the 11 prespecified secondary outcomes, no important variation was explicated by six of them. Compared with high-flow nasal oxygen alone, the proportion of individuals with postextubation respiratory failure at day 7 and reintubation rates up until ICU discharge were considerably lower with high-flow nasal oxygen and NIV. ICU mortality rates were not markedly distinctive ie, 6% and 9% with high-flow nasal oxygen and NIV and with high-flow nasal oxygen alone, respectively. Hence, in mechanically ventilated individuals at great risk of extubation failure, in comparison with high-flow nasal oxygen alone, using high-flow nasal oxygen with NIV right after extubation considerably reduced the risk of reintubation.