Predictors of HFNC Failure in Patients With AHRF Using Diaphragm Ultrasound

Predictors of High-Flow Nasal Cannula Failure (HFNC) in Patients With Acute Hypoxemic Respiratory Failure (AHRF) Using Diaphragm Ultrasound Parameters

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT06096376

Acronym

ULTRAFLOW

Enrollment

Registered

2023-10-23

Start date

2023-04-28

Completion date

2024-09-01

Last updated

2024-10-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Acute Hypoxemic Respiratory Failure

Keywords

Acute Hypoxemic Respiratory Failure, High Flow Nasal Cannula, Diaphragm Ultrasound

Brief summary

Ultrasound of the diaphragm is an easily reproducible bedside tool that provides a non-invasive measurement of inspiratory muscle function and respiratory efficiency. The diaphragmatic thickness correlates with the strength and muscle shortening and is reflective of its contribution to the respiratory workload. Diaphragm thickening fraction (DTF) has been shown to be predictive of extubation failure in ventilated patients. However, whether measurements of DTF are predictive of high flow nasal cannula (HFNC) outcomes in patients with acute hypoxemic respiratory failure (AHRF) remains unknown. The objective of this study is to identify predictors of HFNC failure by diaphragm ultrasound and to compare its performance with the well-established ROX index.

Interventions

DIAGNOSTIC_TESTDiaphragm Ultrasound

Diaphragm ultrasound to assess respiratory muscle function and respiratory efficiency

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to 100 Years

Healthy volunteers

Inclusion criteria

* Age ≧ 18; AND * Acute hypoxemic respiratory failure (AHRF), defined by respiratory rate of greater than 25 breaths per minute and a ratio of the PaO2 to the fraction of inspired oxygen (PaO2 / FiO2) of less than 300, and use of accessory muscles of respiration or paradoxical abdominal motion; AND * Required ventilatory support with high-flow nasal cannula (HFNC)

Exclusion criteria

* Patients suffering from hypercapnic respiratory failure; OR * AHRF secondary to conditions that are indicated for non-invasive ventilation (NIV) (e.g. acute exacerbation of COPD, cardiogenic pulmonary edema); OR * Use of NIV or invasive mechanical ventilation (IMV) prior to HFNC initiation; OR * Patients with imminent need for endotracheal intubation and invasive mechanical ventilation (IMV); OR * Patients with known or suspected diaphragm paralysis; OR * Pregnancy; OR * Patients with abdominal compartment syndrome; OR * Use of HFNC for more than 12 hours prior to ICU admission; OR * Patients with suboptimal diaphragm ultrasound image quality for data processing; OR

Design outcomes

Primary

Measure	Time frame	Description
High flow nasal cannula (HFNC) therapeutic failure	From the start of recruitment into study (i.e. start of HFNC use), till the date of study endpoint (i.e., step up to non-invasive ventilation, intubation, death on HFNC, or weaned off HFNC, whichever came first), assessed up to 4 weeks.	Predictive value of diaphragm ultrasound in detecting high flow nasal cannula (HFNC)therapeutic failure in patients with acute hypoxemic respiratory failure (AHRF)

Countries

Hong Kong

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026