Correlation of Peak Tidal Inspiratory Flow Measured Before and After Extubation in Adult Patients With Hypoxemia

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

5 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-07

Study Completion Date

2023-08-08

Brief Summary

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In this study, patients who are ready for extubation and indicated for high-flow nasal cannula therapy after extubation will be enrolled, the investigators would measure the patient peak tidal inspiratory flow (PTIF) pre and post extubation to explore the correlation between the two PTIFs. Moreover, different HFNC flows would be applied, to explore the patient response in terms of oxygenation and lung aeration to different flow ratios that matched and are above post-extubation PTIF.

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Detailed Description

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High-flow nasal cannula (HFNC) oxygen therapy has been shown to improve oxygenation, reduce the need for intubation for patients with acute hypoxemic respiratory failure (AHRF) and avoid reintubation for post-extubation patients who had high-risk factors. HFNC refers to the delivery of gas at flows that exceed the patient peak inspiratory flow during tidal breathing, However, patient peak tidal inspiratory flow (PTIF) is found to vary greatly among different patients, from 20 to 50 L/min, making it difficult to properly set HFNC in a way to achieve the desired effects. In two recently published studies in intubated patients, PTIF varied from 25-65 L/min or 40-80 L/min, thus this study aims to investigate the correlation between pre-extubation PTIF in different modalities of SBT and post-extubation PTIF for adult patients, who are indicated to use HFNC immediately after extubation. In addition, the investigators aim to explore the patient response in terms of oxygenation and lung aeration to different flow ratios that matched and are above post-extubation PTIF.

Conditions

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Hypoxemic Respiratory Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Patients will be randomized to receive different HFNC flow settings (matching their peak tidal inspiratory flow \[PTIF\], 1.33 times of PTIF, 1.67 times of PTIF and 2 times of PTIF)

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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HFNC flow set at patient peak tidal inspiratory flow

HFNC flow will be set at the level that matches patient peak tidal inspiratory flow

Group Type ACTIVE_COMPARATOR

HFNC flow set at patient peak tidal inspiratory flow

Intervention Type OTHER

HFNC flow will be set at the level equal to patient peak tidal inspiratory flow

HFNC flow set at 1.33 times of patient peak tidal inspiratory flow

HFNC flow will be set at the level that is 1.33 times of patient peak tidal inspiratory flow

Group Type EXPERIMENTAL

HFNC flow set at 1.33 times of patient peak tidal inspiratory flow

Intervention Type OTHER

HFNC flow will be set at 1.33 times of patient peak tidal inspiratory flow

HFNC flow set at 1.67 times of patient peak tidal inspiratory flow

HFNC flow will be set at the level that is 1.67 times of patient peak tidal inspiratory flow

Group Type EXPERIMENTAL

HFNC flow set at 1.67 times of patient peak tidal inspiratory flow

Intervention Type OTHER

HFNC flow will be set at 1.67 times of patient peak tidal inspiratory flow

HFNC flow set at 2 times of patient peak tidal inspiratory flow

HFNC flow will be set at the level that is 2 times of patient peak tidal inspiratory flow

Group Type EXPERIMENTAL

HFNC flow set at 2 times of patient peak tidal inspiratory flow

Intervention Type OTHER

HFNC flow will be set 2 times of patient peak tidal inspiratory flow

Interventions

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HFNC flow set at patient peak tidal inspiratory flow

HFNC flow will be set at the level equal to patient peak tidal inspiratory flow

Intervention Type OTHER

HFNC flow set at 1.33 times of patient peak tidal inspiratory flow

HFNC flow will be set at 1.33 times of patient peak tidal inspiratory flow

Intervention Type OTHER

HFNC flow set at 1.67 times of patient peak tidal inspiratory flow

HFNC flow will be set at 1.67 times of patient peak tidal inspiratory flow

Intervention Type OTHER

HFNC flow set at 2 times of patient peak tidal inspiratory flow

HFNC flow will be set 2 times of patient peak tidal inspiratory flow

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adult intubated patients aged between 18 to 90 years
* Pass spontaneous breathing trial and receive the order to be extubated
* Have at least one of the indications to use HFNC after extubation

Exclusion Criteria

* Need to use inhaled epoprostenol via HFNC
* Pregnant
* Unable to use resuscitation mask, such as facial trauma, claustrophobia
* Non-English speaker
* Inability to verbally communicate
* Using extracorporeal membrane oxygenation (ECMO)
* Hemodynamically unstable
* Difficult airway

Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No