High-flow Nasal Cannula Oxygen Therapy With or Without NIV During the Weaning Period

Conditions

Acute Respiratory Failure Requiring Reintubation

Brief summary

Prospective multicenter randomized controlled open-label trial comparing 2 strategies of oxygenation during the post-extubation period in ICU patients at high risk of extubation failure. Patients will be randomized and assigned to one of the two groups, with a 1:1 ratio.

Arnaud W. Thille, Rémi Coudroy, Mai-Anh Nay, Arnaud Gacouin, Maxens Decavèle et al. (81 authors)

American Journal of Respiratory and Critical Care Medicine2021-11-2367 citations

10.1164/rccm.202106-1452oc

Non-invasive ventilation versus high-flow nasal oxygen for postextubation respiratory failure in ICU: a post-hoc analysis of a randomized clinical trial

Arnaud W. Thille, Grégoire Monseau, Rémi Coudroy, Mai-Anh Nay, Arnaud Gacouin et al. (82 authors)

Critical Care2021-06-2825 citations

10.1186/s13054-021-03621-6

Non-invasive ventilation alternating with high-flow nasal oxygen versus high-flow nasal oxygen alone after extubation in COPD patients: a post hoc analysis of a randomized controlled trial

Arnaud W. Thille, Rémi Coudroy, Mai-Anh Nay, Arnaud Gacouin, Maxens Decavèle et al. (29 authors)

Annals of Intensive Care2021-02-0928 citations

10.1186/s13613-021-00823-7

Effect of Postextubation High-Flow Nasal Oxygen With Noninvasive Ventilation vs High-Flow Nasal Oxygen Alone on Reintubation Among Patients at High Risk of Extubation Failure

Arnaud W. Thille, Grégoire Müller, Arnaud Gacouin, Rémi Coudroy, Maxens Decavèle et al. (37 authors)

JAMA2019-10-02323 citations

10.1001/jama.2019.14901

High-flow nasal cannula oxygen therapy alone or with non-invasive ventilation during the weaning period after extubation in ICU: the prospective randomised controlled HIGH-WEAN protocol

Arnaud W. Thille, Grégoire Müller, Arnaud Gacouin, Rémi Coudroy, Alexandre Demoule et al. (33 authors)

BMJ Open2018-09-0114 citations

10.1136/bmjopen-2018-023772

Interventions

DEVICEHFNC

Gas flow of 50 l/min and FiO2 adjusted to obtain SpO2 ≥ 92%

DEVICENIV

Pressure-support level to achieve an expired tidal volume between 6 and 8 ml/kg and PEEP level of 5 cm H2O with FiO2 adjusted to obtain SpO2 ≥ 92%

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Duration of mechanical ventilation prior to extubation at least 24h * Planned extubation decided by the physician in charge of the patient after success of a weaning trial * Patients at high risk of reintubation according to the following criteria: patients older than 65 years, or those having any underlying chronic cardiac or lung disease.

Exclusion criteria

* Patient admitted for traumatic brain injury * Periphal neuromuscular disease as reason for intubation * Usual lon-term treatment with NIV for chronic desease * Usual lon-term treatment with CPAP for obstructive apneas syndrome * Contraindication to NIV * Unplanned extubation * Do-not-reintubated order at time of extubation * Terminal extubation for end of life * People under legal protection * Opposition to participate

Design outcomes

Primary

Measure	Time frame	Description
Reintubation at Day 7	up to 7 days	The rate of reintubation will be assessed within the 7 days following planned extubation

Countries

France

Outcome results

None listed