Weaning From High Flow Nasal Oxygen in Acute Respiratory Failure : a Target Trial Emulation

Weaning From High Flow Nasal Oxygen in Acute Respiratory Failure : a Target Trial Emulation From Nouvelle-Aquitaine Health Data Warehouses

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT07030413

Acronym

HFNO-Weaning

Enrollment

2000

Registered

2025-06-22

Start date

2019-11-01

Completion date

2025-12-31

Last updated

2025-08-08

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

Conditions

High-Flow Nasal Oxygen Therapy, Respiratory Failure, ICU, Respiratory Failure With Hypoxia

Keywords

high-flow nasal oxygen therapy, acute hypoxemic respiratory failure, weaning

Brief summary

Acute respiratory failure is a frequent reason for admission to the intensive care unit (ICU). It is associated with high healthcare consumption and mortality. High-flow nasal oxygen (HFNO) improves comfort, reduces the risk of intubation and may reduce the risk of mortality in the most severe patients with acute hypoxemic respiratory failure compared with other oxygenation strategies. Therefore, HFNO is recommended as a first-line non-invasive oxygenation strategy in acute hypoxemic respiratory failure. The timing of weaning patients from HFNO is complex. On the one hand, failure to wean from HFNO is associated with prolonged duration of HFNO and prolonged ICU stay. On the other hand, continued HFNO in patients ready to be weaned may unnecessarily prolong ICU stay and contribute to overwhelming of ICU capacities. The overarching goal of this study is to identify the characteristics of patients in whom weaning from HFNO is not beneficial.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Adult patients (age \> 18) * Admitted to participating ICUs * Treated with HFNO at the attending physician's discretion for acute respiratory failure (defined as respiratory rate ≥ 25 breaths/min)

Exclusion criteria

* Prophylactic HFNO to prevent reintubation after extubation * Noninvasive ventilation before HFNO initiation

Design outcomes

Primary

Measure	Time frame	Description
Hospital-free days at day 90	90 days	The number of days alive out of hospital between pseudorandomization and D90. For patients who died, the hospital-free days at day 90 will be equal to 0.

Secondary

Measure	Time frame	Description
Duration of intensive care unit (ICU) stay	90 days	The number of days spent in the ICU
ICU mortality	90 days	The number (and proportion) of patients who died in the ICU
Survival at day 90	90 days	The number (and proportion) of patients alive at day 90 from pseudorandomization

Countries

France

Outcome results