American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended oxygen therapy after extubation for low-risk nonsurgical patients?

1. High-flow nasal cannula for 48 hours

2. Conventional oxygen by nasal cannula

3. High-flow nasal cannula for 24 hours

4. Non-rebreather mask for 24 hours

The correct answer is: High-flow nasal cannula for 24 hours

The recommended approach for oxygen therapy after extubation in low-risk nonsurgical patients is to provide high-flow nasal cannula for a duration of 24 hours. This method enhances comfort and delivers a higher concentration of oxygen while effectively assisting with respiratory demands. High-flow nasal cannula therapy can deliver humidified and heated oxygen, which helps maintain adequate oxygen saturation levels and reduces the work of breathing in patients recovering from extubation. It also provides a degree of positive airway pressure, which can be beneficial during the recovery phase, enhancing lung recruitment and facilitating optimal gas exchange. In contrast, using conventional oxygen by nasal cannula might not provide sufficient assistance for patients immediately after extubation, as it typically delivers lower concentrations of oxygen. Similarly, a non-rebreather mask, while effective for delivering high concentrations of oxygen, may not be as comfortable or necessary for low-risk patients and can lead to increased anxiety or discomfort post-extubation. High-flow nasal cannula for 48 hours may be excessive for low-risk patients and can complicate management without additional benefits. Therefore, a 24-hour duration of high-flow nasal cannula is considered both sufficient and beneficial in this patient population.