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Identifying the Best Flow Setting Strategy for High-Flow Nasal Cannula

RecruitingNAAges 18 Years - anyAllNational Taiwan University Hospital
NCT07007715 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

The goal of this randomized trial is to compare four different flow-setting approaches for post-extubation use of high-flow nasal cannula (HFNC). Selecting the appropriate flow rate when initiating HFNC oxygen therapy is both crucial and challenging for clinicians, as the physiological benefits of HFNC depend significantly on the flow rate. To date, there are no guidelines or consensus on flow-rate setting and weaning for HFNC oxygen therapy. The investigators hypothesized that physiological marker-guided flow setting using peak tidal inspiratory flow (PTIF) or PaO₂/FiO₂ ratios lead to better extubation outcomes as compared to empirical flow setting of 40 L/min or 60 L/min. Participants will be randomly assigned to one of four study groups with different flow setting strategies summarized as follows: (1) Setting flow at 40 L/min, (2) Setting flow at 5 L/min above the peak tidal inspira

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📋 Eligibility rules (as published)
Inclusion Criteria: * Intubated and receiving mechanical ventilation for more than 24 hours * Ready for planned extubation after passing a spontaneous breathing trial * PaO2/FiO2 \<350 mmHg on the day of extubation Exclusion Criteria: * Age \<18 years * On do-not-reintubate code * Pregnant women * Having tracheostomies * Infeasibility of using HFNC * Planning to use preventive NIV after extubation by the primary care team * Life expectancy less than one month
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What it tests

  • Flow of 40L/min
  • Peak tidal inspiratory flow (PTIF) guided
  • PaO2/FiO2 ratio guided
  • Flow of 60L/min
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Where

1 site
National Taiwan University Hospital
Taipei, Taiwan
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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